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Provider Information for 1396756912

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. DAVID J HERNANDEZ MD

Gender: MALE

Individual NPI: 1396756912

Calendar   Last Updated:  2016-01-10
  Certification Date: 

Details

Name Value
NPI 1396756912
Enumeration Date 2006-08-10
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 22030 SHERMAN WAY STE 215
CANOGA PARK, CA 91303-1883
United States

Phone: 818-883-2273 | Fax: 818-347-4257
View Map External Link
Primary Practice Address 22030 SHERMAN WAY STE 215
CANOGA PARK, CA 91303-1883
United States

Phone: 818-883-2273 | Fax: 818-347-4257
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID CA 1538130893
Other PROG GRP # CA HAP70769F
Other CDC PROGRAM GRP # CA BCP70769F
Other MEDICARE RAILROAD # CA P00275711
MEDICAID CA FHC70769F
Other TAX ID # CA 952662606
Other PROGRAM GRP # CA EAP70468F
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207R00000X - Internal Medicine CA G48343
No 207QA0505X - Family Medicine Adult Medicine CA G48343