Provider Demographics
NPI:1588210967
Name:AGUILAR, PAUL ALEJANDRO
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:ALEJANDRO
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 1:1744 CAROM WAY UNIT 4
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91915-2396
Mailing Address - Country:US
Mailing Address - Phone:619-955-9452
Mailing Address - Fax:
Practice Address - Street 1:3709 GLEN VERDE CT
Practice Address - Street 2:
Practice Address - City:BONITA
Practice Address - State:CA
Practice Address - Zip Code:91902-2622
Practice Address - Country:US
Practice Address - Phone:619-955-9452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-12
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA690276164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse