Provider Demographics
NPI:1184828824
Name:HERNANDEZ, GEORGINE F (MPT)
Entity Type:Individual
Prefix:
First Name:GEORGINE
Middle Name:F
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7221 COMSTOCK AVE
Mailing Address - Street 2:UNIT A
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-1350
Mailing Address - Country:US
Mailing Address - Phone:626-851-5927
Mailing Address - Fax:
Practice Address - Street 1:7221 COMSTOCK AVE
Practice Address - Street 2:UNIT A
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-1350
Practice Address - Country:US
Practice Address - Phone:626-851-5927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21117225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist