Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | A94731 | CA |
NPI | 1033190970 |
---|---|
Provider Name | Melinda Luz Aquino |
First Address | San Francisco, CA 94159-0455 |
Second Address | San Francisco, CA 94117-1078 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 17/12/2019 |