Basic Information
| Provider Information | |||||||||
| NPI: | 1902272909 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HNI MEDICAL SERVICES OF CALIFORNIA PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 512 VICTORIA LN | ||||||||
| Address2: | SUITE 12 | ||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785503226 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9564406300 | ||||||||
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| Practice Location | |||||||||
| Address1: | 39000 BOB HOPE DR | ||||||||
| Address2: | |||||||||
| City: | RANCHO MIRAGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922703221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9564406300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2015 | ||||||||
| LastUpdateDate: | 07/16/2019 | ||||||||
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| AuthorizedOfficialLastName: | BLAKE | ||||||||
| AuthorizedOfficialFirstName: | HUGO | ||||||||
| AuthorizedOfficialMiddleName: | G. | ||||||||
| AuthorizedOfficialTitleorPosition: | AUTHORIZED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 1257303056 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 137241 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.