MEDICARE: RICHARD B. AGUILAR, P.C.

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	207R00000X	Internal Medicine Physician	G62147	CA

General Provider Information

NPI Number	:	1942452719
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD B. AGUILAR, P.C.

Provider Business Mailing Address
First Line	:	7705 SEVILLE AVE
Second Line	:	SUITE B
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-6315
Country	:	US
Telephone Number	:	323-582-7406
Fax Number	:	323-582-1862

Provider Business Practice Location Address
First Line	:	7705 SEVILLE AVE
Second Line	:	SUITE B
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-6315
Country	:	US
Telephone Number	:	323-582-7406
Fax Number	:	323-582-1862

Authorized Official
Title or Position	:	MEDICAL DIRECTOR/M.D.
Name	:	DR. RICHARD BURT AGUILAR
Credential	:	M.D.
Telephone Number	:	323-582-7406

Provider Enumeration Date	:	10/10/2008
Last Update Date	:	12/03/2010

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