Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 43493 | CA |
NPI | 1053786491 |
---|---|
Provider Name | Dr. David Thomas Hernandez |
First Address | Walnut Creek, CA 94598-8396 |
Second Address | Walnut Creek, CA 94598-2512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2015 |
Last Update Date | 10/12/2015 |