Healthcare Provider Details

I. General information

NPI: 1427095819
Provider Name (Legal Business Name): FLORY ISABEL AGUILAR-ONDERDONK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4870 BARRANCA PKWY SUITE 220
IRVINE CA
92604-4709
US

IV. Provider business mailing address

4870 BARRANCA PKWY SUITE 220
IRVINE CA
92604-4709
US

V. Phone/Fax

Practice location:
  • Phone: 949-552-4624
  • Fax: 949-552-4622
Mailing address:
  • Phone: 949-552-4624
  • Fax: 949-552-4622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberG80667
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: