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NPI Code Detail

MEDICARE: DR. JAVIER HERNANDEZ M.D.

MEDICARE: DR. JAVIER HERNANDEZ M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianA77736CA

General Provider Information

NPI Number : 1144318734
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAVIER HERNANDEZ M.D.
Provider Business Mailing Address
First Line : 852 E DANENBERG DR
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-8517
Country : US
Telephone Number : 760-344-9951
Fax Number :
Provider Business Practice Location Address
First Line : 91275 66TH AVE
Second Line : 500
City : MECCA
State : CA
Zip : 92254-1251
Country : US
Telephone Number : 760-396-1249
Fax Number : 760-396-1253
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 10/11/2024

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