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General NPI Number Information
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NPI Number | 1477995504
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Entity Type | Individual
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Provider Name | NELSON AGUILAR PA
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Gender | Male
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Dates
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Enumeration Date | 07/17/2013
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 8134 SPECTRUM
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City | IRVINE
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State | CA
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Zip | 92618-7359
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Country | US
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Telephone | 904-657-8524
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Fax |
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Provider Business Mailing Address
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Address Line | 5475 N VIA SEMPREVERDE
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City | TUCSON
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State | AZ
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Zip | 85750-5973
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Country | US
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Telephone | 714-718-4286
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 7652
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License Number State | AZ
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