Provider Demographics
NPI:1437556479
Name:HERNANDEZ, MATTHEW DELEON (NMD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:DELEON
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6885 E COCHISE RD APT 242
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-1407
Mailing Address - Country:US
Mailing Address - Phone:210-393-5040
Mailing Address - Fax:
Practice Address - Street 1:7054 E COCHISE RD
Practice Address - Street 2:SUITE B-200
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85253-4546
Practice Address - Country:US
Practice Address - Phone:480-360-0115
Practice Address - Fax:844-685-0302
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-19
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14-1474175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath