Provider Demographics
NPI:1144316464
Name:HUGHES, BRETT A (DC)
Entity type:Individual
Prefix:MR
First Name:BRETT
Middle Name:A
Last Name:HUGHES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 COFFEE RD
Mailing Address - Street 2:STE J5
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-2416
Mailing Address - Country:US
Mailing Address - Phone:209-523-2225
Mailing Address - Fax:209-523-5445
Practice Address - Street 1:2020 COFFEE RD
Practice Address - Street 2:STE J5
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-2416
Practice Address - Country:US
Practice Address - Phone:209-523-2225
Practice Address - Fax:209-523-5445
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17949111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0179490Medicare ID - Type Unspecified