Active NPI
Cuauhtemoc M Hernandez, A.B.O.C.
- Optician
- Colton, CA
National Provider Identifier
1477922292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- SL6678
- Practice address
- 807 N la Cadena Dr
Colton, CA 92324-2747 - Phone
- (909) 856-1728
- NPI assigned
- Sep 22, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | SL6678 | CA | Primary |
Addresses
Primary practice location
807 N la Cadena Dr
Colton, CA 92324-2747
Mailing address
1172 W 45TH St
San Bernardino, CA 92407-4971
Phone (909) 856-1728
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL6678 | CA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442880000000",
"number": "1477922292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1172 W 45TH ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924074971",
"telephone_number": "909-856-1728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "807 N LA CADENA DR",
"city": "COLTON",
"state": "CA",
"postal_code": "923242747",
"telephone_number": "909-856-1728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "CUAUHTEMOC",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "A.B.O.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-22",
"last_updated": "2015-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "CA",
"license": "SL6678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.