Provider Demographics
NPI:1417049479
Name:HUBBARD, GAIL LYNN (AUD)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:LYNN
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 N EL CAMINO REAL
Mailing Address - Street 2:SUITE A202
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1328
Mailing Address - Country:US
Mailing Address - Phone:760-479-2100
Mailing Address - Fax:760-479-2101
Practice Address - Street 1:477 N EL CAMINO REAL
Practice Address - Street 2:SUITE A202
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1328
Practice Address - Country:US
Practice Address - Phone:760-479-2100
Practice Address - Fax:760-479-2101
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU660231H00000X, 231HA2500X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU660OtherLICENSE NUMBER
CAAU0006600Medicaid
CAAUD660Medicare PIN