Provider Demographics
NPI:1417978537
Name:MELLIJOR-SOLIGUEN, AURORA V (MD)
Entity Type:Individual
Prefix:DR
First Name:AURORA
Middle Name:V
Last Name:MELLIJOR-SOLIGUEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1183 E. FOOTHILL
Mailing Address - Street 2:STE 234
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-5183
Mailing Address - Country:US
Mailing Address - Phone:909-949-0076
Mailing Address - Fax:909-931-7777
Practice Address - Street 1:1183 E FOOTHILL BLVD.
Practice Address - Street 2:STE 234
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-5183
Practice Address - Country:US
Practice Address - Phone:909-949-0076
Practice Address - Fax:909-931-7777
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0636602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1036930Medicaid
CAG62505Medicare UPIN
CA1036930Medicaid