Provider Demographics
NPI:1467643197
Name:VIRGINIA A. AGUILAR, M.D., INC.
Entity Type:Organization
Organization Name:VIRGINIA A. AGUILAR, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:M,D,
Authorized Official - Phone:562-869-7007
Mailing Address - Street 1:1600 W PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-2410
Mailing Address - Country:US
Mailing Address - Phone:562-869-7007
Mailing Address - Fax:
Practice Address - Street 1:7862 FIRESTONE BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4221
Practice Address - Country:US
Practice Address - Phone:562-869-7007
Practice Address - Fax:562-862-6418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39198173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA39198Medicare UPIN