Healthcare Provider Details

I. General information

NPI: 1992640924
Provider Name (Legal Business Name): BRIAN HERNANDEZ PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 SAN VICENTE BLVD STE B
SANTA MONICA CA
90402-2321
US

IV. Provider business mailing address

22438 GEORGIA LN
SANTA CLARITA CA
91350-4323
US

V. Phone/Fax

Practice location:
  • Phone: 310-393-0202
  • Fax:
Mailing address:
  • Phone: 661-993-4006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number91970
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: