Provider Demographics
NPI:1912926767
Name:HUGHES, SHEILA LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:LOUISE
Last Name:HUGHES
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 1:11645 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 702
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1708
Mailing Address - Country:US
Mailing Address - Phone:310-966-4780
Mailing Address - Fax:
Practice Address - Street 1:11645 WILSHIRE BLVD
Practice Address - Street 2:SUITE 702
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1708
Practice Address - Country:US
Practice Address - Phone:310-966-4780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG87869207Q00000X, 207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA600-30220OtherBCBSGA
AL009918535Medicaid
GA761002816AMedicaid
AL51515497OtherBCBSAL
ALP00026363Medicare PIN
GA08BBXLFMedicare ID - Type Unspecified
AL51515497OtherBCBSAL
ALE02466Medicare UPIN
GAE02466Medicare UPIN
GAP00026339Medicare ID - Type UnspecifiedRR MEDICARE