Provider Demographics
NPI:1215980107
Name:AGUILA, DANIEL G (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:G
Last Name:AGUILA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 E THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-8034
Mailing Address - Country:US
Mailing Address - Phone:602-470-5000
Mailing Address - Fax:
Practice Address - Street 1:5825 E CALLE GUADALUPE
Practice Address - Street 2:
Practice Address - City:GUADALUPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-2664
Practice Address - Country:US
Practice Address - Phone:480-344-6000
Practice Address - Fax:480-344-6001
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16122207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ340703Medicaid
AZZ63965Medicare PIN
AZZ134076Medicare PIN
AZD25719Medicare UPIN