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General NPI Number Information
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NPI Number | 1588210967
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Entity Type | Individual
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Provider Name | PAUL ALEJANDRO AGUILAR
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Gender | Male
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Dates
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Enumeration Date | 08/12/2019
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | 3709 GLEN VERDE CT
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City | BONITA
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State | CA
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Zip | 91902-2622
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Country | US
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Telephone | 619-955-9452
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Fax |
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Provider Business Mailing Address
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Address Line | 1744 CAROM WAY UNIT 4
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City | CHULA VISTA
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State | CA
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Zip | 91915-2396
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Country | US
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Telephone | 619-955-9452
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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 | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 690276
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License Number State | CA
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