Healthcare Provider Details

I. General information

NPI: 1275140576
Provider Name (Legal Business Name): ARNEL AGUINALDO PHD, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2020
Last Update Date: 09/30/2020
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 LOMALAND DR
SAN DIEGO CA
92106-2899
US

IV. Provider business mailing address

1476 VENTERS DR
CHULA VISTA CA
91911-6908
US

V. Phone/Fax

Practice location:
  • Phone: 619-849-3007
  • Fax:
Mailing address:
  • Phone: 619-250-0184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code246ZB0301X
TaxonomyBiomedical Engineer
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: