Individual
CECILIA M HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2450 ASHBY AVE RM 5505, BERKELEY, CA 94705-2067
(510) 204-4444
(510) 649-8287
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(510) 204-1893
(510) 649-8287
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G77974
CA
208M00000X
Hospitalist Physician
Primary
G77974
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G779740
—
CA
01
—
G77974
STATE LICENSE
CA
Enumeration date
09/02/2006
Last updated
03/17/2020
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