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NPI Code Detail

MEDICARE: KELLY ALEXIS HUGHES D.O.

MEDICARE: KELLY ALEXIS HUGHES D.O.
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
1208000000XPediatrics Physician17085CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2R1071OTHERAZTRAINING PERMIT

General Provider Information

NPI Number : 1164606828
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY ALEXIS HUGHES D.O.
Provider Business Mailing Address
First Line : 4900 CALIFORNIA AVE STE 400B
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93309-7081
Country : US
Telephone Number : 661-459-1900
Fax Number : 661-459-1944
Provider Business Practice Location Address
First Line : 4900 CALIFORNIA AVE STE 400B
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93309-7081
Country : US
Telephone Number : 661-459-1900
Fax Number : 661-459-1944
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2007
Last Update Date : 04/18/2019

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