Provider Demographics
NPI:1790732527
Name:HERNANDEZ, MICHAEL GERALD (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:GERALD
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 1:1600 RIVIERA AVE
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-3569
Mailing Address - Country:US
Mailing Address - Phone:800-660-7983
Mailing Address - Fax:925-951-1385
Practice Address - Street 1:1600 RIVIERA AVE
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-3569
Practice Address - Country:US
Practice Address - Phone:800-660-7983
Practice Address - Fax:925-951-1385
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG253680207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology