Individual
JAIME D HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6815 NOBLE AVE, VAN NUYS, CA 91405-3796
(818) 901-6600
Mailing address
6815 NOBLE AVE, VAN NUYS, CA 91405-3796
(818) 901-6600
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A110306
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DH580Z
MEDICARE PTAN
CA
Enumeration date
05/12/2009
Last updated
03/15/2011
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