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General NPI Number Information
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NPI Number | 1861546681
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Entity Type | Organization
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Legal Business Name | LARRY C HUGHES MD INC A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 12/23/2014
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Provider Practice Location Address
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Address Line | 4020 W FLORIDA AVE
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City | HEMET
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State | CA
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Zip | 92545-5279
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Country | US
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Telephone | 951-925-9565
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Fax |
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Provider Business Mailing Address
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Address Line | 4020 W FLORIDA AVE
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City | HEMET
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State | CA
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Zip | 92545-5279
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Country | US
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Telephone | 951-925-9565
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LARRY C HUGHES
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Credential | M.D.
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Telephone | 951-925-9565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number | G59842
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | G59842
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | G59842
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G59842
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License Number State | CA
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