Provider Demographics
NPI:1700963097
Name:HOBBS, JOSEPH D (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:D
Last Name:HOBBS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 GATEWAY DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-3317
Mailing Address - Country:US
Mailing Address - Phone:916-434-1623
Mailing Address - Fax:916-434-1625
Practice Address - Street 1:160 GATEWAY DR
Practice Address - Street 2:SUITE 110
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-3317
Practice Address - Country:US
Practice Address - Phone:916-434-1623
Practice Address - Fax:916-434-1625
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA13367363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA13367OtherLICENSE
CA0PA133670OtherID
CAMH0602789OtherDEA
CAMH0602789OtherDEA
CA0PA133670OtherID