Provider Demographics
NPI:1639500267
Name:BRILEY, AARON
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:BRILEY
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:PO BOX 9974
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92658-1974
Mailing Address - Country:US
Mailing Address - Phone:949-214-4172
Mailing Address - Fax:
Practice Address - Street 1:1822 VERANO PL
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92617-3121
Practice Address - Country:US
Practice Address - Phone:949-214-4172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-08
Last Update Date:2013-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies