MEDICARE: AARON BELTRAN AG-ACNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	95006969	CA

General Provider Information

NPI Number	:	1104349869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON BELTRAN AG-ACNP

Provider Business Mailing Address
First Line	:	1244 RIDLEY AVE
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-1945
Country	:	US
Telephone Number	:	323-718-3793
Fax Number	:

Provider Business Practice Location Address
First Line	:	1244 RIDLEY AVE
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-1945
Country	:	US
Telephone Number	:	323-718-3793
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2017
Last Update Date	:	07/24/2017

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