Provider Demographics
NPI:1164243911
Name:A&W MEDICAL PC
Entity type:Organization
Organization Name:A&W MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:DNP PMNHNP
Authorized Official - Phone:925-400-7355
Mailing Address - Street 1:2603 CAMINO RAMON
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-9137
Mailing Address - Country:US
Mailing Address - Phone:925-400-7355
Mailing Address - Fax:
Practice Address - Street 1:2603 CAMINO RAMON
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-9137
Practice Address - Country:US
Practice Address - Phone:925-400-7355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-23
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty