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General NPI Number Information
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NPI Number | 1144471939
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Entity Type | Organization
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Legal Business Name | THREE ANGELS MEDICAL PROFESSIONAL CORP.
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Dates
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Enumeration Date | 10/10/2008
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 99 BUSINESS PARK DR
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City | PERRIS
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State | CA
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Zip | 92571-3165
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Country | US
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Telephone | 951-956-2131
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Fax | 951-956-2150
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Provider Business Mailing Address
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Address Line | 99 BUSINESS PARK DR
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City | PERRIS
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State | CA
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Zip | 92571-3165
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Country | US
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Telephone | 951-956-2131
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Fax | 951-956-2150
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID HERNANDEZ
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Credential | MD
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Telephone | 951-956-2131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A102591
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License Number State | CA
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