Physician Compare National (NPI:1801930318)

HEALTHCARE PROVIDER:

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1801930318
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8426168048
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120224000425
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HERNANDEZ
	Individual professional last name
Provider First Name	FEDERICO
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1980
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1665 S IMPERIAL AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE A
	Group Practice or individual's line 2 address
City	EL CENTRO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	922434247
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6193526062
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y