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General NPI Number Information
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NPI Number | 1689073611
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Entity Type | Individual
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Provider Name | DEREK PATRICK HUGHES M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 02/05/2016
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Provider Practice Location Address
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Address Line | 5959 GREENBACK LN SUITE 500
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95621-4700
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Country | US
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Telephone | 916-725-1177
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Fax |
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Provider Business Mailing Address
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Address Line | 1312 GERRY WAY
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City | ROSEVILLE
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State | CA
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Zip | 95661-3431
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Country | US
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Telephone | 530-415-1413
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A61410
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License Number State | CA
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