Provider Demographics
NPI:1598781031
Name:HULSTEDT, DOUGLAS V (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:V
Last Name:HULSTEDT
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 1:498 VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2624
Mailing Address - Country:US
Mailing Address - Phone:831-402-8310
Mailing Address - Fax:
Practice Address - Street 1:147 EL DORADO ST STE C
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3127
Practice Address - Country:US
Practice Address - Phone:831-333-1207
Practice Address - Fax:831-333-9894
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA4239702080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine