Provider Demographics
NPI:1316311509
Name:HERNANDEZ, JOSE JOAQUIN ESTALILLA (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE JOAQUIN
Middle Name:ESTALILLA
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 BROOKLYN AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9677
Mailing Address - Country:US
Mailing Address - Phone:661-304-8791
Mailing Address - Fax:
Practice Address - Street 1:5900 BROOKLYN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9677
Practice Address - Country:US
Practice Address - Phone:661-205-2075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-25
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA204074208G00000X, 208D00000X, 207P00000X, 2086S0127X, 208600000X, 2086S0102X
CAF4062086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care