Healthcare Provider Details

I. General information

NPI: 1588839997
Provider Name (Legal Business Name): AARON JOSEPH AHEARN MD-PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SUPERIOR AVE
NEWPORT BEACH CA
92663-3657
US

IV. Provider business mailing address

PO BOX 31309
LOS ANGELES CA
90031-0309
US

V. Phone/Fax

Practice location:
  • Phone: 949-764-5793
  • Fax: 949-764-5792
Mailing address:
  • Phone: 323-442-5908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberA103008
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number262959
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: