Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | A127188 | CA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | A127188 | CA |
NPI | 1255698155 |
---|---|
Provider Name | Johanna Aguilar Estrada |
First Address | San Diego, CA 92172-1536 |
Second Address | San Diego, CA 92121-1518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2012 |
Last Update Date | 30/11/2021 |