MEDICARE: MARIA G HUGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WW0101X	Ambulatory Women's Health Care Registered Nurse	456981	CA
2	363LW0102X	Women's Health Nurse Practitioner	456981	CA

General Provider Information

NPI Number	:	1881730240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA G HUGUEZ

Provider Business Mailing Address
First Line	:	1000 SAN GABRIEL BLVD STE 200
Second Line	:
City	:	ROSEMEAD
State	:	CA
Zip	:	91770-4394
Country	:	US
Telephone Number	:	323-724-0019
Fax Number	:	323-248-7044

Provider Business Practice Location Address
First Line	:	2237 W BALL RD
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804
Country	:	US
Telephone Number	:	714-490-2750
Fax Number	:	714-400-2757

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	06/19/2019

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