Healthcare Provider Details

I. General information

NPI: 1104150614
Provider Name (Legal Business Name): H R FERNANDEZ MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2009
Last Update Date: 09/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

842 S AKERS ST
VISALIA CA
93277-8309
US

IV. Provider business mailing address

PO BOX 26773
FRESNO CA
93729-6773
US

V. Phone/Fax

Practice location:
  • Phone: 559-740-4094
  • Fax: 559-740-4100
Mailing address:
  • Phone: 559-436-0871
  • Fax: 559-436-5221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: HECTOR R FERNANDEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 559-436-0871