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General NPI Number Information
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NPI Number | 1285948927
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Entity Type | Organization
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Legal Business Name | AGUILUZ MEDICAL CORPORATION, INC
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Dates
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Enumeration Date | 08/05/2010
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Last Update Date | 08/05/2010
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Provider Practice Location Address
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Address Line | 10970 SHERMAN WAY
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City | BURBANK
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State | CA
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Zip | 91505-1002
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Country | US
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Telephone | 818-847-1007
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Fax |
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Provider Business Mailing Address
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Address Line | 10970 SHERMAN WAY
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City | BURBANK
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State | CA
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Zip | 91505-1002
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Country | US
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Telephone | 818-847-1007
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JACQUELINE B AGUILUZ
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Credential | D.O.
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Telephone | 562-533-3279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 20A7451
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License Number State | CA
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