Provider Demographics
NPI:1134316128
Name:HERNANDEZ, EMILIA TOLARBA (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMILIA
Middle Name:TOLARBA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:EMILIA
Other - Middle Name:TOLARBA
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1483 E PLAZA BLVD
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-3613
Mailing Address - Country:US
Mailing Address - Phone:619-474-6858
Mailing Address - Fax:619-474-6858
Practice Address - Street 1:1483 E PLAZA BLVD
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-3613
Practice Address - Country:US
Practice Address - Phone:619-474-6858
Practice Address - Fax:619-474-6858
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA386941223G0001X, 124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No124Q00000XDental ProvidersDental Hygienist