Provider Demographics
NPI:1285782151
Name:HERNANDEZ, RALPH C (MD)
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:C
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2937 BEYER BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-4604
Mailing Address - Country:US
Mailing Address - Phone:619-423-0343
Mailing Address - Fax:619-423-0340
Practice Address - Street 1:2937 BEYER BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-4604
Practice Address - Country:US
Practice Address - Phone:619-423-0343
Practice Address - Fax:619-423-0340
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC42207207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine