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NPI Code Detail

MEDICARE: STEVEN HERNANDEZ D.D.S.

MEDICARE: STEVEN HERNANDEZ D.D.S.
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
1122300000XDentist37836CA

General Provider Information

NPI Number : 1588779953
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN HERNANDEZ D.D.S.
Provider Business Mailing Address
First Line : 9560 BASELINE RD
Second Line : SUITE B
City : ALTA LOMA
State : CA
Zip : 91701-6435
Country : US
Telephone Number : 909-987-7676
Fax Number :
Provider Business Practice Location Address
First Line : 9560 BASELINE RD
Second Line : SUITE B
City : ALTA LOMA
State : CA
Zip : 91701-6435
Country : US
Telephone Number : 909-987-7676
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2006
Last Update Date : 07/08/2007

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