Individual
TOBY NATIVIDAD HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
MWTC BLDG 3005 STATE ROUTE 108, ATTN: MEDICAL, BRIDGEPORT, CA 93517
(760) 932-1616
Mailing address
103 MAUSER COURT, COLEVILLE, CA 96107
(760) 932-1611
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/26/2008
Last updated
09/26/2008
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