Provider Demographics
NPI:1679710644
Name:AGUILAR, HECTOR MANUEL (PA)
Entity Type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:MANUEL
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7281 W MENLO AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93723-9349
Mailing Address - Country:US
Mailing Address - Phone:559-647-3679
Mailing Address - Fax:559-445-0316
Practice Address - Street 1:2505 MERCED ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1811
Practice Address - Country:US
Practice Address - Phone:559-445-0391
Practice Address - Fax:559-445-0316
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20147363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA20147OtherPHYSICIAN ASSISTANT COMMITTEE, THE MEDICAL BOARD OF CALIFORNIA