Provider Demographics
NPI:1225105653
Name:RANEY, AIDAN A JR (MD)
Entity Type:Individual
Prefix:DR
First Name:AIDAN
Middle Name:A
Last Name:RANEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 OLD NEWPORT BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4257
Mailing Address - Country:US
Mailing Address - Phone:949-650-3350
Mailing Address - Fax:949-650-1274
Practice Address - Street 1:447 OLD NEWPORT BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4257
Practice Address - Country:US
Practice Address - Phone:949-650-3350
Practice Address - Fax:949-650-1274
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG27564208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G275640D06Medicaid
CA1750339479OtherGROUP NPI
CAG27564OtherLICENSE
CAGR002729OtherMEDI-CAL GROUP NUMBER
CAGR002729OtherMEDI-CAL GROUP NUMBER
CAWG27564AMedicare PIN
CAA43402Medicare UPIN