Provider Demographics
NPI:1073515920
Name:HUBER, TIMOTHY EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:EDWARD
Last Name:HUBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2809 OLIVE HWY STE 220
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-6133
Mailing Address - Country:US
Mailing Address - Phone:530-532-8584
Mailing Address - Fax:520-532-8433
Practice Address - Street 1:2809 OLIVE HWY STE 220
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-6133
Practice Address - Country:US
Practice Address - Phone:530-532-8584
Practice Address - Fax:520-532-8433
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30256207Q00000X
CAC52370207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine