Healthcare Provider Details

I. General information

NPI: 1881345171
Provider Name (Legal Business Name): ALEX Y HERNANDEZ, MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2022
Last Update Date: 01/18/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 E FIR AVE STE 101
FRESNO CA
93720-3859
US

IV. Provider business mailing address

PO BOX 25042
FRESNO CA
93729-5042
US

V. Phone/Fax

Practice location:
  • Phone: 559-298-9600
  • Fax: 559-298-9605
Mailing address:
  • Phone: 559-892-4500
  • Fax: 559-892-4550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. BETTE STANFORD
Title or Position: CEO
Credential:
Phone: 559-438-4500