Provider Demographics
NPI:1508420464
Name:BLOCH, AARON SOLOMON
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:SOLOMON
Last Name:BLOCH
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 1:719 SONRISA ST
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2407
Mailing Address - Country:US
Mailing Address - Phone:856-296-3301
Mailing Address - Fax:
Practice Address - Street 1:28078 BAXTER RD STE 450
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-1405
Practice Address - Country:US
Practice Address - Phone:951-677-3000
Practice Address - Fax:951-672-4171
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-26
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA194522208800000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208800000XAllopathic & Osteopathic PhysiciansUrology