MEDICARE: MICHELLE LEE HUBERT N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	16065	CA
2	363L00000X	Nurse Practitioner	16065	CA

General Provider Information

NPI Number	:	1942483250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE LEE HUBERT N.P.

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD STE 400
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	625 S FAIR OAKS AVE
Second Line	:	SUITE 320
City	:	PASADENA
State	:	CA
Zip	:	91105-2613
Country	:	US
Telephone Number	:	626-396-2999
Fax Number	:	626-396-2991

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2007
Last Update Date	:	02/18/2026

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