Doctor Name: | MARK A HYATT |
NPI Number: | 1437283793 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CADC II |
License Number: | 18601206 |
Business Practice Address: | 838 Beach Ct Coloma, CA - 96513 |
Business Phone Number: | 5306267252 |
Business Fax Number: | |
Mailing Address: | 10556 Combie Rd, Pmb 6418 AUBURN |
State: | CA |
Postal Code: | 956028908 |
Phone Number: | 5305593524 |
Fax Number: | |
NPI Enumeration Date: | 03/16/2007 |
NPI Last Update Date: | 11/20/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 18601206 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |