Healthcare Provider Details

I. General information

NPI: 1780786061
Provider Name (Legal Business Name): WILLIAM P AIELLO MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 07/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10921 CHERRY STREET #200
LOS ALAMITOS CA
90720
US

IV. Provider business mailing address

10921 CHERRY STREET #200
LOS ALAMITOS CA
90720
US

V. Phone/Fax

Practice location:
  • Phone: 562-594-5996
  • Fax: 562-493-1021
Mailing address:
  • Phone: 562-594-5996
  • Fax: 562-493-1021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA40489
License Number StateCA

VIII. Authorized Official

Name: DR. WILLIAM P AIELLO
Title or Position: PRESIDENT
Credential: MD
Phone: 562-594-5996