Healthcare Provider Details

I. General information

NPI: 1013376698
Provider Name (Legal Business Name): AEI & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2016
Last Update Date: 02/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10605 BALBOA BLVD
GRANADA HILLS CA
91344-6342
US

IV. Provider business mailing address

10061 RIVERSIDE DR SUITE 409
TOLUCA LAKE CA
91602-2560
US

V. Phone/Fax

Practice location:
  • Phone: 818-419-6659
  • Fax: 818-559-9571
Mailing address:
  • Phone: 818-419-6659
  • Fax: 818-559-9571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberA72336
License Number StateCA

VIII. Authorized Official

Name: DR. DEIRDRE WASHINGTON
Title or Position: PRESIDENT
Credential: MD
Phone: 818-419-6659