Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 20020272 | NM |
NPI | 1356436539 |
---|---|
Provider Name | Cesar J. Hernandez |
First Address | Albuquerque, NM 87106-5214 |
Second Address | Albuquerque, NM 87106-5214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 15/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1063439800 | NPI GROUP (01) | NM |
12134805 | (05) | NM |
200521050 | MEDICARE GROUP (01) | NM |
95822739 | MEDICAID GROUP (01) | NM |
H70751 | (02) | |
OONM001009 | BCBS (01) | NM |