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Individual

MR. CUAUHTEMOC M HERNANDEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
A.B.O.C.

Contact information

Practice address
807 N LA CADENA DR, COLTON, CA 92324-2747
(909) 856-1728
Mailing address
1172 W 45TH ST, SAN BERNARDINO, CA 92407-4971
(909) 856-1728

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
SL6678
CA

Other

Enumeration date
09/22/2015
Last updated
09/22/2015
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