Provider Demographics
NPI:1649680810
Name:MAY AGUILAR
Entity type:Organization
Organization Name:MAY AGUILAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PONDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-315-1265
Mailing Address - Street 1:22992 SERRA DR
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-4966
Mailing Address - Country:US
Mailing Address - Phone:424-558-2582
Mailing Address - Fax:
Practice Address - Street 1:22992 SERRA DR
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-4966
Practice Address - Country:US
Practice Address - Phone:424-558-2582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9500567311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home