Active NPI
German Ernesto Fernandez, P.A.
- Physician Assistant
- Los Angeles, CA
National Provider Identifier
1922287929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA18790
- Practice address
- 4214 Beverly Blvd Ste 212
Los Angeles, CA 90004-4429 - Phone
- (213) 385-9912
- Fax
- (213) 385-9915
- NPI assigned
- Oct 26, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA18790 | CA | Primary |
Addresses
Primary practice location
4214 Beverly Blvd Ste 212
Los Angeles, CA 90004-4429
Mailing address
4214 Beverly Blvd Ste 212
Los Angeles, CA 90004-4429
Phone (213) 385-9912
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA18790 | Other | CA | STATE OF CALIFORNIA |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA18790 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193356800000",
"number": "1922287929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4214 BEVERLY BLVD STE 212",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900044429",
"telephone_number": "213-385-9912",
"fax_number": "213-385-9915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4214 BEVERLY BLVD STE 212",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900044429",
"telephone_number": "213-385-9912",
"fax_number": "213-385-9915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "GERMAN",
"middle_name": "ERNESTO",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-26",
"last_updated": "2007-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA18790",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF CALIFORNIA",
"identifier": "PA18790",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.