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Organization
RUSSELL BRUCE HUBBARD MD INC
Active
Organization
RUSSELL BRUCE HUBBARD MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL BRUCE HUBBARD M.D. (OWNER)
(619) 295-8005
Entity
Organization
Contact information
Practice address
1565 HOTEL CIR S STE 310, SAN DIEGO, CA 92108-3419
(619) 295-8005
(619) 297-1700
Mailing address
PO BOX 1770, LA MESA, CA 91944-1770
(619) 295-8005
(619) 297-1700
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125585700
OWCPACS (DEPT. LABOR WC)
CA
01
—
G25680
MEDICAL LICENSE #
CA
Enumeration date
03/27/2007
Last updated
04/22/2020
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