Provider Demographics
NPI:1861458002
Name:ARCE-HERNANDEZ, EDSEL (MD)
Entity Type:Individual
Prefix:DR
First Name:EDSEL
Middle Name:
Last Name:ARCE-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 1:9300 VALLEY CHILDRENS PL
Mailing Address - Street 2:SUITE G270
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93638-8761
Mailing Address - Country:US
Mailing Address - Phone:559-353-6450
Mailing Address - Fax:559-353-7214
Practice Address - Street 1:9300 VALLEY CHILDRENS PL
Practice Address - Street 2:SUITE G270
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-8761
Practice Address - Country:US
Practice Address - Phone:559-353-6450
Practice Address - Fax:559-353-7214
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN385832080P0216X
CAC523772080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H27153Medicare UPIN
TN3896264Medicare ID - Type Unspecified
3896264Medicare ID - Type Unspecified