Provider Demographics
NPI:1902929425
Name:AGUILAR, DIONICIO M
Entity Type:Individual
Prefix:
First Name:DIONICIO
Middle Name:M
Last Name:AGUILAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3104
Mailing Address - Country:US
Mailing Address - Phone:415-401-2700
Mailing Address - Fax:415-401-2741
Practice Address - Street 1:2712 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3104
Practice Address - Country:US
Practice Address - Phone:415-401-2700
Practice Address - Fax:415-401-2741
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
7806OtherCBHS INTERNAL USE ONLY-COMMERCIAL NUMBER
7806OtherSFGH INTERNAL USE ONLY