Healthcare Provider Details

I. General information

NPI: 1851361695
Provider Name (Legal Business Name): PAUL E HUGHES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SOUTH ELLSWORTH AVENUE SUITE 504
SAN MATEO CA
94401
US

IV. Provider business mailing address

100 SOUTH ELLSWORTH AVENUE SUITE 504
SAN MATEO CA
94401-3956
US

V. Phone/Fax

Practice location:
  • Phone: 650-343-5633
  • Fax: 650-343-3122
Mailing address:
  • Phone: 650-343-5633
  • Fax: 650-343-3122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberA78391
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: