Provider Demographics
NPI:1679260376
Name:HUBNER, NICOLAI ALEXANDER (MD)
Entity Type:Individual
Prefix:
First Name:NICOLAI
Middle Name:ALEXANDER
Last Name:HUBNER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4860 Y ST STE 3500
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2307
Mailing Address - Country:US
Mailing Address - Phone:916-734-2893
Mailing Address - Fax:916-734-8094
Practice Address - Street 1:4860 Y ST STE 2200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2309
Practice Address - Country:US
Practice Address - Phone:916-734-2222
Practice Address - Fax:916-734-7676
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAF764208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology