Provider Demographics
NPI:1760021976
Name:HERNANDEZ, GERARDO TAPIA (NP)
Entity type:Individual
Prefix:
First Name:GERARDO
Middle Name:TAPIA
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6255 W SUNSET BLVD FL 21
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7422
Mailing Address - Country:US
Mailing Address - Phone:323-860-5200
Mailing Address - Fax:323-467-7119
Practice Address - Street 1:3920 CEDAR SPRINGS RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-3518
Practice Address - Country:US
Practice Address - Phone:214-599-2173
Practice Address - Fax:214-443-3880
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP142338363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology