MEDICARE: RAQUEL DOLOR AGUIRRE

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1750866158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAQUEL DOLOR AGUIRRE

Provider Business Mailing Address
First Line	:	2435 W ARLINGTON ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90810-2009
Country	:	US
Telephone Number	:	310-800-6292
Fax Number	:

Provider Business Practice Location Address
First Line	:	2435 W ARLINGTON ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90810-2009
Country	:	US
Telephone Number	:	310-800-6292
Fax Number	:

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

Provider Enumeration Date	:	10/02/2018
Last Update Date	:	10/02/2018

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Directions to “ RAQUEL DOLOR AGUIRRE ” Practice Location

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