=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942452719
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RICHARD B. AGUILAR, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2008
-----------------------------------------------------
Last Update Date | 12/03/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7705 SEVILLE AVE SUITE B
-----------------------------------------------------
City | HUNTINGTON PARK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90255-6315
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-582-7406
-----------------------------------------------------
Fax | 323-582-1862
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7705 SEVILLE AVE SUITE B
-----------------------------------------------------
City | HUNTINGTON PARK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90255-6315
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-582-7406
-----------------------------------------------------
Fax | 323-582-1862
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DIRECTOR/M.D.
-----------------------------------------------------
Name | DR. RICHARD BURT AGUILAR
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 323-582-7406
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | G62147
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------