Provider Demographics
NPI:1316135742
Name:HERNANDEZ, MARIA CHRISTINA (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:CHRISTINA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:880 S ATLANTIC BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-4773
Mailing Address - Country:US
Mailing Address - Phone:626-457-5579
Mailing Address - Fax:626-457-1269
Practice Address - Street 1:3355 E GAGE AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-5530
Practice Address - Country:US
Practice Address - Phone:323-835-6677
Practice Address - Fax:323-835-6679
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA40070208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA40070AMedicare PIN