Provider Demographics
NPI:1518991983
Name:HERNANDEZ, ARMAND RICHAUD (MD)
Entity Type:Individual
Prefix:DR
First Name:ARMAND
Middle Name:RICHAUD
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 1:1329 SPANOS CT STE C4
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-2806
Mailing Address - Country:US
Mailing Address - Phone:209-525-3176
Mailing Address - Fax:209-525-3177
Practice Address - Street 1:1329 SPANOS CT STE C4
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-2806
Practice Address - Country:US
Practice Address - Phone:209-525-3176
Practice Address - Fax:209-525-3177
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG72645208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G726450Medicaid