Provider Demographics
NPI:1750866158
Name:AGUIRRE, RAQUEL DOLOR
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:DOLOR
Last Name:AGUIRRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 W ARLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90810-2009
Mailing Address - Country:US
Mailing Address - Phone:310-800-6292
Mailing Address - Fax:
Practice Address - Street 1:2435 W ARLINGTON ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90810-2009
Practice Address - Country:US
Practice Address - Phone:310-800-6292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care