Healthcare Provider Details

I. General information

NPI: 1407331432
Provider Name (Legal Business Name): RAUL H AGUILAR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 09/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4867 W SUNSET BLVD
LOS ANGELES CA
90027-5969
US

IV. Provider business mailing address

8741 HOLBROOK ST
PICO RIVERA CA
90660-2666
US

V. Phone/Fax

Practice location:
  • Phone: 323-783-8320
  • Fax:
Mailing address:
  • Phone: 562-948-2468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number24682
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: