MEDICARE: DANIEL HENRY AGUILERA MSW PHD

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	104100000X	Social Worker	LCS6644	CA

General Provider Information

NPI Number	:	1891881017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL HENRY AGUILERA MSW PHD

Provider Business Mailing Address
First Line	:	4028 E FLORENCE AVE
Second Line	:
City	:	BELL
State	:	CA
Zip	:	90201-3404
Country	:	US
Telephone Number	:	213-201-2786
Fax Number	:	213-989-7701

Provider Business Practice Location Address
First Line	:	123 S ALVARADO STREET
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2201
Country	:	US
Telephone Number	:	213-989-7700
Fax Number	:	213-989-7702

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/08/2007

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