Provider Demographics
NPI:1619058237
Name:AGUILAR, CHRISTINE M (MD)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:M
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:747 52ND STREET
Mailing Address - Street 2:CHILDRENS HOSPITAL AND RESEARCH CENTER-OAKLAND
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609
Mailing Address - Country:US
Mailing Address - Phone:510-428-3655
Mailing Address - Fax:510-450-5821
Practice Address - Street 1:747 52ND STREET
Practice Address - Street 2:CHILDRENS HOSPITAL AND RESEARCH CENTER-OAKLAND
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609
Practice Address - Country:US
Practice Address - Phone:510-428-3655
Practice Address - Fax:510-450-5821
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG060095225400000X
NV9361225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
00G600950Medicare ID - Type Unspecified
2145128Medicare UPIN