Provider Demographics
NPI:1417016122
Name:HUGHES, MARY J (CRNA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:J
Last Name:HUGHES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:420 E 3RD ST
Mailing Address - Street 2:SUITE 1005
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-1644
Mailing Address - Country:US
Mailing Address - Phone:213-935-8795
Mailing Address - Fax:213-935-8786
Practice Address - Street 1:420 E 3RD ST
Practice Address - Street 2:SUITE 1005
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-1644
Practice Address - Country:US
Practice Address - Phone:213-935-8795
Practice Address - Fax:213-935-8786
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANA2760367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered