Provider Demographics
NPI:1306985254
Name:D KENT HOBERT MD INC
Entity type:Organization
Organization Name:D KENT HOBERT MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MASHORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-228-6517
Mailing Address - Street 1:1210 ALHAMBRA AVE
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553
Mailing Address - Country:US
Mailing Address - Phone:925-228-6517
Mailing Address - Fax:925-228-9145
Practice Address - Street 1:1210 ALHAMBRA AVE
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-2314
Practice Address - Country:US
Practice Address - Phone:925-228-6517
Practice Address - Fax:925-228-9145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00C299220207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A88924Medicare UPIN
CA00C299220Medicare Oscar/Certification