| David J. Hernandez Md A Professional Medical Corporation | |
|
22119 Sherman Way Canoga Park CA 91303-1137 | |
| (747) 226-3650 | |
| (747) 226-3670 |
| Full Name | David J. Hernandez Md A Professional Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 22119 Sherman Way, Canoga Park, California |
| Authorized Official Name and Position | David Jacinto Hernandez (DIRECTOR) |
| Authorized Official Contact | 7472263650 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David J. Hernandez Md A Professional Medical Corporation 22119 Sherman Way Canoga Park CA 91303-1137 Ph: (747) 226-3650 | David J. Hernandez Md A Professional Medical Corporation 22119 Sherman Way Canoga Park CA 91303-1137 Ph: (747) 226-3650 |
| NPI Number | 1912417007 |
|---|---|
| Provider Enumeration Date | 10/03/2017 |
| Last Update Date | 01/27/2022 |
| Medicare PECOS PAC ID | 8022377829 |
|---|---|
| Medicare Enrollment ID | O20180124003359 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912417007 | NPI | - | NPPES |
| 00G483431 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | G48343 (California) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | David J Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396756912 PECOS PAC ID: 4486812922 Enrollment ID: I20120423000555 |
| Provider Name | Joan K Dawson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164555488 PECOS PAC ID: 6608865050 Enrollment ID: I20190513000129 |
| Provider Name | Maria Therese Dela Merced |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255971743 PECOS PAC ID: 1153779376 Enrollment ID: I20231129001283 |
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