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General NPI Number Information
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NPI Number | 1225659006
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Entity Type | Individual
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Provider Name | THOMAS HERNANDEZ PA-C
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Gender | Male
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Dates
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Enumeration Date | 05/03/2020
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 2 BON AIR RD STE 100
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City | LARKSPUR
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State | CA
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Zip | 94939-1144
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Country | US
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Telephone | 415-927-0666
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Fax | 415-927-6159
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Provider Business Mailing Address
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Address Line | 2 BON AIR RD STE 100
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City | LARKSPUR
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State | CA
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Zip | 94939-1144
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Country | US
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Telephone | 415-927-0666
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Fax | 415-927-6159
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA64797
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License Number State | CA
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