Provider Demographics
NPI:1801211529
Name:ARAGON, MARINO
Entity Type:Individual
Prefix:
First Name:MARINO
Middle Name:
Last Name:ARAGON
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 1:2253 COLDWATER CANYON DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-1736
Mailing Address - Country:US
Mailing Address - Phone:213-252-5800
Mailing Address - Fax:310-783-4874
Practice Address - Street 1:19700 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-1100
Practice Address - Country:US
Practice Address - Phone:213-252-5800
Practice Address - Fax:310-783-4874
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator