Healthcare Provider Details

I. General information

NPI: 1720310592
Provider Name (Legal Business Name): ALEX YASSER HERNANDEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2010
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 W ASHLAN AVE STE 102
CLOVIS CA
93612-4742
US

IV. Provider business mailing address

875 W ASHLAN AVE STE 102
CLOVIS CA
93612-4742
US

V. Phone/Fax

Practice location:
  • Phone: 559-533-2273
  • Fax: 559-578-4277
Mailing address:
  • Phone: 559-533-2273
  • Fax: 559-578-4277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number46692
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC153842
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: