Provider Demographics
NPI:1003914516
Name:HUGHES, MARY BETH (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY BETH
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:15899 LOS GATOS ALMADEN RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-3739
Mailing Address - Country:US
Mailing Address - Phone:408-356-7770
Mailing Address - Fax:408-356-7774
Practice Address - Street 1:15899 LOS GATOS ALMADEN RD
Practice Address - Street 2:SUITE 4
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-3739
Practice Address - Country:US
Practice Address - Phone:408-356-7770
Practice Address - Fax:408-356-7774
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG69138208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000G69138000Medicaid
CA000G69138000Medicaid