Individual
DR. DIANNE HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
275 W HERNDON AVE, CLOVIS, CA 93612-0204
(559) 324-6200
(559) 324-6280
Mailing address
PO BOX 28949, FRESNO, CA 93729-8949
(559) 228-4200
(559) 224-3920
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G62199
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G621990
BLUE CROSS/BLUE SHIELD
CA
05
—
00G621990
—
CA
01
—
77040368493612B007
CHAMPUS
CA
Enumeration date
11/08/2005
Last updated
06/02/2020
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