Provider Demographics
NPI:1407255813
Name:AGUILAR, MAY (RNP)
Entity Type:Individual
Prefix:
First Name:MAY
Middle Name:
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20703 IBEX AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90715-1533
Mailing Address - Country:US
Mailing Address - Phone:424-558-2585
Mailing Address - Fax:
Practice Address - Street 1:22992 SERRA DR
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-4966
Practice Address - Country:US
Practice Address - Phone:424-558-2582
Practice Address - Fax:310-830-1180
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-21
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF95000567363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANPF95000567Medicare UPIN