Provider Demographics
NPI:1962685974
Name:HERNANDEZ AND NAGAL, APC
Entity Type:Organization
Organization Name:HERNANDEZ AND NAGAL, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGAL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:619-474-7279
Mailing Address - Street 1:450 E 8TH ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2300
Mailing Address - Country:US
Mailing Address - Phone:619-474-7279
Mailing Address - Fax:
Practice Address - Street 1:450 E 8TH ST
Practice Address - Street 2:SUITE E
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2300
Practice Address - Country:US
Practice Address - Phone:619-474-7279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB449541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA592672-01OtherDENTICAL