Provider Demographics
NPI:1730143124
Name:GARCIA-AGUILAR, JULIO E (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:E
Last Name:GARCIA-AGUILAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIO
Other - Middle Name:
Other - Last Name:AGUILAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 5063
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91017-7163
Mailing Address - Country:US
Mailing Address - Phone:626-775-3200
Mailing Address - Fax:626-775-3271
Practice Address - Street 1:1500 DUARTE RD
Practice Address - Street 2:
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-3012
Practice Address - Country:US
Practice Address - Phone:626-359-8111
Practice Address - Fax:626-775-3271
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50820208600000X, 2086X0206X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0C5082000Medicaid
CAG35880Medicare UPIN
CA0C5082000Medicaid