Individual
JAIME HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2604 S VERMONT AVE STE F, LOS ANGELES, CA 90007-2298
(323) 731-3333
Mailing address
7520 S BROADWAY, LOS ANGELES, CA 90003-2086
(323) 330-5003
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
71254
CA
Other
Enumeration date
01/12/2009
Last updated
01/12/2009
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