Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301084071 | MI |
N | 111NI0900X | Internist | 4301084071 | MI |
N | 208000000X | Pediatrician | 4301084071 | MI |
N | 2080P0202X | Pediatric Cardiologist | 4301084071 | MI |
Y | 2080P0202X | Pediatric Cardiologist | A119874 | CA |
NPI | 1154507952 |
---|---|
Provider Name | Dr. Paolo Manere Aquino |
First Address | Madera, CA 93636-8761 |
Second Address | Madera, CA 93636-8761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2008 |
Last Update Date | 09/03/2020 |