Individual
MR. CARLOS HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 E RIENSTRA ST, #13, CHULA VISTA, CA 91911-5255
(619) 271-6233
Mailing address
20 E RIENSTRA ST, #13, CHULA VISTA, CA 91911-5255
(619) 271-6233
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
C4081219
CA
Other
Enumeration date
09/23/2008
Last updated
09/23/2008
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