Healthcare Provider Details

I. General information

NPI: 1316311509
Provider Name (Legal Business Name): JOSE JOAQUIN ESTALILLA HERNANDEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2015
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 BROOKLYN AVE
BAKERSFIELD CA
93311-9677
US

IV. Provider business mailing address

5900 BROOKLYN AVE
BAKERSFIELD CA
93311-9677
US

V. Phone/Fax

Practice location:
  • Phone: 661-205-2075
  • Fax:
Mailing address:
  • Phone: 661-304-8791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberA204074
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberF406
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA204074
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberA204074
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberTP01671
License Number StateAZ
# 6
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberA204074
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA204074
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberA204074
License Number StateCA
# 9
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA204074
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: