Healthcare Provider Details

I. General information

NPI: 1467643197
Provider Name (Legal Business Name): VIRGINIA A. AGUILAR, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 08/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7862 FIRESTONE BLVD
DOWNEY CA
90241-4221
US

IV. Provider business mailing address

1600 W PICO BLVD
LOS ANGELES CA
90015-2410
US

V. Phone/Fax

Practice location:
  • Phone: 562-869-7007
  • Fax: 562-862-6418
Mailing address:
  • Phone: 562-869-7007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberA39198
License Number StateCA

VIII. Authorized Official

Name: VIRGINIA A AGUILAR
Title or Position: PRESIDENT
Credential: M,D,
Phone: 562-869-7007