Individual
BRYAN ALEXANDER HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, PA-C
Contact information
Practice address
2400 S AVENUE A, YUMA, AZ 85364-7127
(928) 334-2000
Mailing address
2400 S AVENUE A, YUMA, AZ 85364-7127
(928) 334-2000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA18782
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114075421
—
CA
05
—
PA18782
—
CA
Enumeration date
01/05/2007
Last updated
06/02/2010
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