Healthcare Provider Details

I. General information

NPI: 1174677207
Provider Name (Legal Business Name): JOSE G HERNANDEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 GARCES HWY
DELANO CA
93215-3660
US

IV. Provider business mailing address

1401 GARCES HWY
DELANO CA
93215-3660
US

V. Phone/Fax

Practice location:
  • Phone: 831-245-9953
  • Fax:
Mailing address:
  • Phone: 831-245-9953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA85712
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: