Provider Information for 1790354322
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ANDREW MICHAEL HERNANDEZ
Sex: Male
NPI: 1790354322
Last Updated: 2024-08-26
Certification Date: 2024-08-26
Certification Date: 2024-08-26
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1790354322 | ||||||||
| Enumeration Date | 2021-06-18 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1396 W HERNDON AVE FRESNO, CA 93711-7126 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 1925 E DAKOTA AVE FRESNO, CA 93726-4821 United States Phone: 559-216-1075 | Fax: | ||||||||
| Secondary Practice Address(es) | 4910 E ASHLAN AVE STE 118 1410 F ST STE 101 | ||||||||
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