Individual
JONATHAN HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
240 W BASELINE RD, MESA, AZ 85210-6107
(480) 668-9518
(480) 668-9520
Mailing address
32493 N WOODSIDE DR, SAN TAN VALLEY, AZ 85143-1658
(661) 904-4801
(480) 668-9520
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO-003378
AZ
Other
Enumeration date
02/26/2025
Last updated
02/26/2025
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