Provider Demographics
NPI:1275616963
Name:HUGHES, GERALD EDWARD JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:EDWARD
Last Name:HUGHES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 NO. JACKSON AVE
Mailing Address - Street 2:SUITE 213
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1909
Mailing Address - Country:US
Mailing Address - Phone:408-251-9200
Mailing Address - Fax:408-251-0690
Practice Address - Street 1:175 NO. JACKSON AVE
Practice Address - Street 2:SUITE 213
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1909
Practice Address - Country:US
Practice Address - Phone:408-251-9200
Practice Address - Fax:408-251-0690
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC34407207W00000X
CAC-34407207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C344070Medicaid
A35614Medicare UPIN
00C344070Medicare PIN
CA00C344070Medicaid