Provider Demographics
NPI:1073944633
Name:AGUILAR, LINDSAY I (BA, CO)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:
Last Name:AGUILAR
Suffix:I
Gender:F
Credentials:BA, CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 E BONITA AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-1926
Mailing Address - Country:US
Mailing Address - Phone:909-660-1231
Mailing Address - Fax:909-625-7535
Practice Address - Street 1:320 E BONITA AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-1926
Practice Address - Country:US
Practice Address - Phone:909-660-1231
Practice Address - Fax:909-625-7535
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5281222Z00000X
CA2902224900000X
CA3476224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy Fitter
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist