Individual
LUIS MANUEL HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4825 OAK ST, PICO RIVERA, CA 90660-2249
(562) 479-8628
Mailing address
4825 OAK ST, PICO RIVERA, CA 90660-2249
(562) 479-8628
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
80912
CA
Other
Enumeration date
07/01/2018
Last updated
07/01/2018
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