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Organization
HURST OSTEOPATHIC MEDICINE, A PROFESSIONAL CORP
Active
Organization
HURST OSTEOPATHIC MEDICINE, A PROFESSIONAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D HURST D.O. (PRESIDENT OF CORPORATION)
(209) 833-0272
Entity
Organization
Contact information
Practice address
1530 BESSIE AVE, SUITE 104, TRACY, CA 95376-3080
(209) 833-0272
(209) 839-8473
Mailing address
1530 BESSIE AVE, SUITE 104, TRACY, CA 95376-3080
(209) 833-0272
(209) 839-8473
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20A8081
CA
208000000X
Pediatrics Physician
20A8081
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX80810
—
CA
Enumeration date
02/08/2011
Last updated
02/08/2011
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