Healthcare Provider Details

I. General information

NPI: 1982721320
Provider Name (Legal Business Name): STEVEN LL ARAGON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4445 MAGNOLIA AVE
RIVERSIDE CA
92501-4135
US

IV. Provider business mailing address

1633 ERRINGER RD 1ST FLOOR
SIMI VALLEY CA
93065-3583
US

V. Phone/Fax

Practice location:
  • Phone: 951-788-3243
  • Fax: 951-788-3633
Mailing address:
  • Phone: 805-578-8300
  • Fax: 805-578-8950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG59121
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberG59121
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: