Provider Demographics
NPI:1770750788
Name:HOOL, FERNANDO (PA-C)
Entity type:Individual
Prefix:MR
First Name:FERNANDO
Middle Name:
Last Name:HOOL
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1000 SAN GABRIEL BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-4394
Mailing Address - Country:US
Mailing Address - Phone:323-724-0019
Mailing Address - Fax:323-248-7044
Practice Address - Street 1:1860 HAMNER AVE
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-2945
Practice Address - Country:US
Practice Address - Phone:951-479-0070
Practice Address - Fax:951-479-0074
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA17103363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPA17103AMedicare PIN