Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 71092 | CA |
NPI | 1093950362 |
---|---|
Provider Name | Mr. Abraham David Aguilar |
First Address | Huntington Park, CA 90255-6825 |
Second Address | Torrance, CA 90501-5645 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2008 |
Last Update Date | 15/12/2008 |