Provider Demographics
NPI:1922311299
Name:ABILIO A. HERNANDEZ, M.D.,INC.
Entity Type:Organization
Organization Name:ABILIO A. HERNANDEZ, M.D.,INC.
Other - Org Name:DBA:PSYCARE COUNSELING CENTER, MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ABILIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-266-0496
Mailing Address - Street 1:4082 WHITTIER BLVD
Mailing Address - Street 2:STE. 104
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90023-2558
Mailing Address - Country:US
Mailing Address - Phone:323-266-0496
Mailing Address - Fax:323-266-4185
Practice Address - Street 1:4082 WHITTIER BLVD
Practice Address - Street 2:STE. 104
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023-2558
Practice Address - Country:US
Practice Address - Phone:323-266-0496
Practice Address - Fax:323-266-4185
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DBA: PSY CARE COUNSELING CENTER, A MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA264632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA26463Medicare PIN