Provider Demographics
NPI:1720054265
Name:HURLBURT, RACHEL K (DO)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:K
Last Name:HURLBURT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 BUCKS LAKE RD
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:CA
Mailing Address - Zip Code:95971
Mailing Address - Country:US
Mailing Address - Phone:530-283-2121
Mailing Address - Fax:530-283-7953
Practice Address - Street 1:1060 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:CA
Practice Address - Zip Code:95971
Practice Address - Country:US
Practice Address - Phone:530-283-5640
Practice Address - Fax:530-283-3541
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7712207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA020A77120Medicaid
CA020A77120Medicare ID - Type Unspecified
H57849Medicare UPIN