Individual ProviderBronte HernandezPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansPractice Address1200 N State Street, Clinic Tower, Suite A7d, Los Angeles, CA 90033-1029(323) 409-6225PECOS EnrollmentBased on the most recent information from CMS, provider Bronte Hernandez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1821679507Provider TypeIndividualFull NameHernandez, BronteCredentialMDGenderFemaleSole ProprietorYesEnumeration Date4/15/2021Last Updated12/26/2024Contact InformationPractice LocationPractice Address1200 N State Street, Clinic Tower, Suite A7d, Los Angeles, CA 90033-1029Phone(323) 409-6225FaxUnlisted FaxMailing LocationMailing Address6215 W Buena Vista Ct, Visalia, CA 93291-8512PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2084P0800XPrimaryDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseA185076CaliforniaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer