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General NPI Number Information
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NPI Number | 1659387629
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Entity Type | Individual
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Provider Name | ROGELIO M HERNANDEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 11/18/2010
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Provider Practice Location Address
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Address Line | 1130 COUNTRY CLUB DR SUITE E
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City | MADERA
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State | CA
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Zip | 93638-1582
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Country | US
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Telephone | 559-673-3297
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Fax | 559-673-3298
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Provider Business Mailing Address
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Address Line | 1130 COUNTRY CLUB DR SUITE E
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City | MADERA
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State | CA
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Zip | 93638-1582
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Country | US
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Telephone | 559-673-3297
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Fax | 559-673-3298
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A49249
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A49249
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License Number State | CA
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