Basic Information
| Provider Information | |||||||||
| NPI: | 1831298389 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AGUIRRE | ||||||||
| FirstName: | RICARDO | ||||||||
| MiddleName: | JESUS | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2866 | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905092866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3107920601 | ||||||||
| FaxNumber: | 3107929062 | ||||||||
| Practice Location | |||||||||
| Address1: | 1300 W 7TH ST | ||||||||
| Address2: | |||||||||
| City: | SAN PEDRO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907323505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3107920601 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A87157 | CA | X | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | A87157 | CA | X | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | A87157 | 01 | CA | LICENSE | OTHER |