1982316618 NPI number — MS. MILENE KRISTIAN HUGHES CPT-1

Table of content: (NPI 1326039546)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982316618 NPI number — MS. MILENE KRISTIAN HUGHES CPT-1

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUGHES
Provider First Name:
MILENE
Provider Middle Name:
KRISTIAN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CPT-1
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982316618
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2108 N ST STE 8581
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95816-5712
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-230-9796
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4254 E AVENUE S4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALMDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93552-5143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-391-9779
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/13/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 246RP1900X , with the licence number:  CPT1001703 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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