Basic Information
| Provider Information | |||||||||
| NPI: | 1386824043 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HERNANDEZ | ||||||||
| FirstName: | CHRISTINA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2851 COMPTON PL | ||||||||
| Address2: | |||||||||
| City: | TRACY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953778534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2099148074 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1180 E SHAW AVE STE 101 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937107812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5592285400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2007 | ||||||||
| LastUpdateDate: | 09/18/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 101109 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.