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General NPI Number Information
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NPI Number | 1922287929
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Entity Type | Individual
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Provider Name | GERMAN ERNESTO FERNANDEZ P.A.
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Gender | Male
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 4214 BEVERLY BLVD STE 212
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City | LOS ANGELES
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State | CA
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Zip | 90004-4429
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Country | US
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Telephone | 213-385-9912
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Fax | 213-385-9915
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Provider Business Mailing Address
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Address Line | 4214 BEVERLY BLVD STE 212
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City | LOS ANGELES
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State | CA
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Zip | 90004-4429
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Country | US
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Telephone | 213-385-9912
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Fax | 213-385-9915
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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 | PA18790
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License Number State | CA
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