# EAR, NOSE & THROAT MEDICAL ASSOCIATES OF THE PENINSULA, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467720722
- **Authorized official:** DR. JENNIFER BOCK HUGHES M.D. (PRESIDENT)
- **Authorized official phone:** (650) 344-6896

## Contact information

- **Practice address:** 100 S ELLSWORTH AVE, SUITE 308, SAN MATEO, CA 94401-3939
- **Practice address phone:** (650) 344-6896
- **Practice address fax:** (650) 344-2794
- **Mailing address:** 322 FRANKLIN ST, SAN MATEO, CA 94402-2214
- **Mailing address phone:** (650) 344-6896
- **Mailing address fax:** (650) 344-2794

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | G071603 | CA | Yes |

## Other

- **Enumeration date:** 12/01/2011
- **Last updated:** 01/05/2012