Healthcare Provider Details

I. General information

NPI: 1952765638
Provider Name (Legal Business Name): JOSE JAVIER HERNANDEZ DURAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JOSE JAVIER HERNANDEZ DURAN

II. Dates (important events)

Enumeration Date: 04/08/2016
Last Update Date: 09/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 N DOUTY ST # 105
HANFORD CA
93230-3722
US

IV. Provider business mailing address

4636 W CALDWELL AVE APT A
VISALIA CA
93277-9332
US

V. Phone/Fax

Practice location:
  • Phone: 559-537-0224
  • Fax:
Mailing address:
  • Phone: 559-790-9165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA157201
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: