Provider Demographics
NPI:1508986555
Name:HUGHES, DAVID T JR
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:T
Last Name:HUGHES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 N LARK ELLEN AVE STE I
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-1099
Mailing Address - Country:US
Mailing Address - Phone:626-430-9253
Mailing Address - Fax:626-430-9255
Practice Address - Street 1:855 N LARK ELLEN AVE STE I
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-1099
Practice Address - Country:US
Practice Address - Phone:626-430-9253
Practice Address - Fax:626-430-9255
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter