Doctor Name: | NICHOLAS Q DE LA MOTTE HURST |
NPI Number: | 1831476506 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA |
License Number: | |
Business Practice Address: | 2525 Erringer Rd Simi Valley, CA - 930652352 |
Business Phone Number: | 8055271404 |
Business Fax Number: | 8055275246 |
Mailing Address: | 3525 Loma Vista Rd, Suite A VENTURA |
State: | CA |
Postal Code: | 930033101 |
Phone Number: | 8056416415 |
Fax Number: | 8056416495 |
NPI Enumeration Date: | 11/09/2011 |
NPI Last Update Date: | 06/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |