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General NPI Number Information
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NPI Number | 1053335406
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Entity Type | Organization
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Legal Business Name | AURORA MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 05/21/2013
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Provider Practice Location Address
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Address Line | 11245 LOWER AZUSA RD
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City | EL MONTE
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State | CA
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Zip | 91731-1411
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Country | US
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Telephone | 626-579-9541
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Fax | 626-579-9604
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Provider Business Mailing Address
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Address Line | 11245 LOWER AZUSA RD
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City | EL MONTE
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State | CA
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Zip | 91731-1411
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Country | US
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Telephone | 626-579-9541
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Fax | 626-579-9604
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Authorized Official
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Title or Position | CEO
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Name | YONG WANG
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Credential | MD
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Telephone | 626-579-9541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A56523
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License Number State | CA
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