Provider Demographics
NPI:1700948684
Name:AGUILAR, MICHAEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:M
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:79 SCRIPPS DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825
Mailing Address - Country:US
Mailing Address - Phone:916-923-3100
Mailing Address - Fax:916-923-3103
Practice Address - Street 1:79 SCRIPPS DR
Practice Address - Street 2:SUITE 202
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825
Practice Address - Country:US
Practice Address - Phone:916-923-3100
Practice Address - Fax:916-923-3103
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG78496208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOG784961Medicaid
CAOOG784960Medicare ID - Type Unspecified
CAOOG784961Medicaid