Provider Demographics
NPI:1427246727
Name:AIELLO, ANDREW BURL (DO)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:BURL
Last Name:AIELLO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6760 DUME DR
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-4223
Mailing Address - Country:US
Mailing Address - Phone:310-699-8650
Mailing Address - Fax:
Practice Address - Street 1:6760 DUME DR
Practice Address - Street 2:
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265-4223
Practice Address - Country:US
Practice Address - Phone:310-699-8650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine