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NPI Code Detail

MEDICARE: DR HERNANDEZ OPTOMETRY INC

MEDICARE: DR HERNANDEZ OPTOMETRY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOPT 7216 TCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164604658
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR HERNANDEZ OPTOMETRY INC
Provider Business Mailing Address
First Line : 6134 PACIFIC BLVD
Second Line :
City : HUNTINGTON PARK
State : CA
Zip : 90255-2923
Country : US
Telephone Number : 323-589-3381
Fax Number : 323-583-6439
Provider Business Practice Location Address
First Line : 6134 PACIFIC BLVD
Second Line :
City : HUNTINGTON PARK
State : CA
Zip : 90255-2923
Country : US
Telephone Number : 323-589-3381
Fax Number : 323-583-6439
Authorized Official
Title or Position : CEO
Name : MR. DAVID HERNANDEZ
Credential :
Telephone Number : 323-589-3381
Provider Enumeration Date : 11/27/2007
Last Update Date : 02/05/2026

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Directions to “DR HERNANDEZ OPTOMETRY INC ” Practice Location

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