Individual
GABRIEL HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1141 W REDONDO BEACH BLVD, SUITE 402, GARDENA, CA 90247-3586
(310) 329-8631
(310) 329-8636
Mailing address
1141 W REDONDO BEACH BLVD, SUITE 402, GARDENA, CA 90247-3586
(310) 329-8631
(310) 329-8636
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PA17831
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA17831
PA LICENSE
CA
Enumeration date
08/18/2006
Last updated
07/08/2007
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