Healthcare Provider Details

I. General information

NPI: 1619081379
Provider Name (Legal Business Name): DAVID R AARONS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 WEST VINE ST STE 14
LODI CA
95240
US

IV. Provider business mailing address

1121 W VINE ST SUITE 14
LODI CA
95240-5137
US

V. Phone/Fax

Practice location:
  • Phone: 209-334-3153
  • Fax: 209-334-6029
Mailing address:
  • Phone: 209-334-3153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberG37817
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: