Organization
FEDERICO R HERNANDEZ DPM A PROFESSIONAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FEDERICO RENE HERNANDEZ DPM (PRESIDENT)
(760) 352-6062
Entity
Organization
Contact information
Practice address
1665 S IMPERIAL AVE, SUITE A, EL CENTRO, CA 92243-4253
(760) 352-6062
(760) 332-0400
Mailing address
PO BOX 318, EL CENTRO, CA 92244-0318
(760) 352-6062
(760) 332-0400
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E1187
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E11871
—
CA
01
—
1801930318
INDIVIDUAL NPI
CA
Enumeration date
01/09/2008
Last updated
02/14/2012
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