Organization
HERNANDEZ & GRADY A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAUL HERNANDEZ MD (PARTNER)
(650) 991-3064
Entity
Organization
Contact information
Practice address
1850 SULLIVAN AVE, #300, DALY CITY, CA 94015
(650) 991-3064
(650) 756-6610
Mailing address
1850 SULLIVAN AVE, #300, DALY CITY, CA 94015
(650) 991-3064
(650) 756-6610
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
A605230
CA
208800000X
Urology Physician
Primary
G673420
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0060000
—
CA
01
—
ZZZ05676Z
BLUE SHIELD
CA
Enumeration date
09/16/2006
Last updated
11/19/2007
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