Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | G36024 | CA |
N | 208000000X | Pediatrician | G36024 | CA |
Y | 2084N0400X | Neurologist | G36024 | CA |
N | 2084N0402X | Child Neurologist | G36024 | CA |
N | 2084N0600X | Clinical Neurophysiologist | G36024 | CA |
NPI | 1831155654 |
---|---|
Provider Name | Harrol Terry Hutchison |
First Address | Fresno, CA 93721-1431 |
Second Address | Fresno, CA 93701-2234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 05/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G360240 | (05) | CA |
6697032 | EDS PIN (01) | CA |
A46553 | (02) | CA |