Provider Demographics
NPI:1114398062
Name:HUGHES, JEFFREY RAYMOND (EMT-P)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:RAYMOND
Last Name:HUGHES
Suffix:
Gender:M
Credentials:EMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47666 ZUNIC DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-7552
Mailing Address - Country:US
Mailing Address - Phone:808-255-6005
Mailing Address - Fax:
Practice Address - Street 1:47666 ZUNIC DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-7552
Practice Address - Country:US
Practice Address - Phone:808-255-6005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIEMT-P1771146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic