Provider Demographics
NPI:1790838860
Name:HUFBAUER, ELLEN (MD)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:HUFBAUER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2185 PACHECO ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2309
Mailing Address - Country:US
Mailing Address - Phone:925-887-5396
Mailing Address - Fax:925-887-5269
Practice Address - Street 1:2185 PACHECO ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2309
Practice Address - Country:US
Practice Address - Phone:925-887-5396
Practice Address - Fax:925-887-5269
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72145207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine