Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 109 | PR |
NPI | 1215112545 |
---|---|
Provider Name | Hilda Janetza Aviles Vargas |
First Address | Pasadena, CA 91110-0698 |
Second Address | Phoenix, AZ 85016-5319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2008 |
Last Update Date | 01/06/2019 |