Provider Demographics
NPI:1831463702
Name:GERALD E HUGHES JR M D MEDICAL CORPORATION
Entity Type:Organization
Organization Name:GERALD E HUGHES JR M D MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:408-251-9200
Mailing Address - Street 1:175 N 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 N 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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-23
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC34407207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty