Healthcare Provider Details

I. General information

NPI: 1225189871
Provider Name (Legal Business Name): AARON GERSHON FILLER M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/29/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 WILSHIRE BLVD STE 310
SANTA MONICA CA
90401-1895
US

IV. Provider business mailing address

900 WILSHIRE BLVD STE 310
SANTA MONICA CA
90401-1895
US

V. Phone/Fax

Practice location:
  • Phone: 310-314-6410
  • Fax: 310-496-0185
Mailing address:
  • Phone: 310-314-6410
  • Fax: 310-496-0185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberG81778
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: