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Organization

EDWARD P. & DIANE M. HERNANDEZ

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDWARD PAUL HERNANDEZ O.D. (OWNER)
(626) 961-0432
Entity
Organization

Contact information

Practice address
15330 AMAR RD STE A, LA PUENTE, CA 91744-2001
(626) 961-0432
(626) 333-7741
Mailing address
15330 AMAR RD STE A, LA PUENTE, CA 91744-2001
(626) 961-0432
(626) 333-7741

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
08489T
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GSD004881
CA
Enumeration date
05/22/2007
Last updated
07/15/2010
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