MEDICARE: ADRIANA V AGUILERA DO

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	207Q00000X	Family Medicine Physician	4678	AZ
2	207Q00000X	Family Medicine Physician	20A13914	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710100706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANA V AGUILERA DO

Provider Business Mailing Address
First Line	:	5341 WARNER AVE
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-4078
Country	:	US
Telephone Number	:	714-477-8450
Fax Number	:

Provider Business Practice Location Address
First Line	:	5341 WARNER AVE
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-4078
Country	:	US
Telephone Number	:	714-477-8450
Fax Number	:

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

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	02/03/2024

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