Provider Demographics
NPI:1275668428
Name:AGUILAR, ERASMO
Entity Type:Individual
Prefix:
First Name:ERASMO
Middle Name:
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16715 S THORSON AVE
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90221-5238
Mailing Address - Country:US
Mailing Address - Phone:310-762-2492
Mailing Address - Fax:
Practice Address - Street 1:6060 N PARAMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-3711
Practice Address - Country:US
Practice Address - Phone:562-790-1860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist