Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A135075 | CA |
N | 207ND0101X | MOHS-Micrographic Surgeon | A135075 | CA |
N | 207NP0225X | Pediatric Dermatologist | A135075 | CA |
N | 207NS0135X | Procedural Dermatology | A135075 | CA |
NPI | 1205255288 |
---|---|
Provider Name | Dr. Kristen Aguirre |
First Address | San Clemente, CA 92672-2356 |
Second Address | Dana Point, CA 92629-2875 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2014 |
Last Update Date | 03/02/2020 |