Basic Information
| Provider Information | |||||||||
| NPI: | 1073515920 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUBER | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | EDWARD | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2809 OLIVE HWY STE 220 | ||||||||
| Address2: | |||||||||
| City: | OROVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959666133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5305328584 | ||||||||
| FaxNumber: | 5205328433 | ||||||||
| Practice Location | |||||||||
| Address1: | 2809 OLIVE HWY STE 220 | ||||||||
| Address2: | |||||||||
| City: | OROVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959666133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5305328584 | ||||||||
| FaxNumber: | 5205328433 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 30256 | TN | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | C52370 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.