Provider Demographics
NPI:1538514153
Name:VINCENT, HUNTER (DO)
Entity Type:Individual
Prefix:
First Name:HUNTER
Middle Name:
Last Name:VINCENT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:HUNTER
Other - Middle Name:
Other - Last Name:MALONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:22287 MULHOLLAND HWY # 526
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-5157
Mailing Address - Country:US
Mailing Address - Phone:805-975-0006
Mailing Address - Fax:
Practice Address - Street 1:4850 Y STREET, SUITE 3850
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:805-975-0006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A152962081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine