Provider Demographics
NPI:1710089677
Name:HUBBARD, DAVID RICHARDSON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RICHARDSON
Last Name:HUBBARD
Suffix:JR
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 1:14781 POMERADO RD
Mailing Address - Street 2:#221
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2802
Mailing Address - Country:US
Mailing Address - Phone:858-668-3380
Mailing Address - Fax:858-668-3384
Practice Address - Street 1:14781 POMERADO RD
Practice Address - Street 2:#221
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2802
Practice Address - Country:US
Practice Address - Phone:858-668-3380
Practice Address - Fax:858-668-3384
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG50317204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM