Provider Demographics
NPI:1952765638
Name:HERNANDEZ DURAN, JOSE JAVIER (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:JAVIER
Last Name:HERNANDEZ DURAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:JAVIER
Other - Last Name:HERNANDEZ DURAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4636 W CALDWELL AVE APT A
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-9332
Mailing Address - Country:US
Mailing Address - Phone:559-790-9165
Mailing Address - Fax:
Practice Address - Street 1:1025 N DOUTY ST # 105
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-3722
Practice Address - Country:US
Practice Address - Phone:559-537-0224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA157201207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine