Provider Demographics
NPI:1306425715
Name:HUFFMAN, GREGORY (PA)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 OUTLET CENTER DR
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-0677
Mailing Address - Country:US
Mailing Address - Phone:805-485-2400
Mailing Address - Fax:805-485-3025
Practice Address - Street 1:1910 OUTLET CENTER DR
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-0677
Practice Address - Country:US
Practice Address - Phone:805-485-2400
Practice Address - Fax:805-485-3025
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-04
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant