Individual provider Active NPI

Fabian Eric Hernandez, D.O.

  • Psychiatry Physician
  • Canoga Park, CA
National Provider Identifier
1467586693
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20A12331 Issued in CA
Practice address
6800 Owensmouth Ave
160
Canoga Park, CA 91303-3159
Phone
(818) 610-6700
Fax
(818) 347-7292
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 20A12331 CA Primary

Addresses

Primary practice location

6800 Owensmouth Ave
160
Canoga Park, CA 91303-3159

Mailing address

6800 Owensmouth Ave
160
Canoga Park, CA 91303-3159
Phone (818) 610-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140109000554 CA Practitioner - Psychiatry 4385810548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11080 W Olympic Blvd
Edmund Edelman
Los Angeles, CA 90064-1937
Phone (310) 966-6538

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A12331CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Oct 26, 2013 Accepting new patients

Locations

11080 W Olympic Blvd
Los Angeles, CA 90064
Phone (310) 966-6500

11080 W Olympic Blvd
Fl 1
Los Angeles, CA 90064
Phone (310) 966-6610

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1467586693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 OWENSMOUTH AVE",
            "address_2": "160",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033159",
            "telephone_number": "818-610-6700",
            "fax_number": "818-347-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 OWENSMOUTH AVE",
            "address_2": "160",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033159",
            "telephone_number": "818-610-6700",
            "fax_number": "818-347-7292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "FABIAN",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A12331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

Verify at the official NPI Registry.