Basic Information
Provider Information
NPI: 1568620904
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUNT
FirstName: JOSEPH
MiddleName: BENJAMIN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 83160
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921383160
CountryCode: US
TelephoneNumber: 6196616500
FaxNumber: 6196617894
Practice Location
Address1: 480 ALTA RD
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921790001
CountryCode: US
TelephoneNumber: 6196616500
FaxNumber: 6196617894
Other Information
ProviderEnumerationDate: 05/31/2008
LastUpdateDate: 05/31/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XC26840CAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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