Most Relevant Information
Provider Data
| NPI Number: | 1003408410 |
| Provider Name: | ROBERTO HERNAL |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 77079 |
Most Important Dates
| Enumeration Date: | 02/07/2021 |
| Last Updated: | 10/06/2021 |
Provider Practice Location
3756 W AVENUE 40 STE 2B
LOS ANGELES
CA
900653667
Practice Location Phone/Fax
| Phone: | 3233442337 |
| Fax: | 3237390094 |
Provider Mailing Location
9446 RALPH ST
ROSEMEAD
CA
917702111
Provider Mailing Phone/Fax
| Phone: | 3233442337 |
| Fax: |