Provider Demographics
NPI:1528163375
Name:APARICIO, LUIS A (MD)
Entity type:Individual
Prefix:MR
First Name:LUIS
Middle Name:A
Last Name:APARICIO
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 1:10300 COMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90002-3628
Mailing Address - Country:US
Mailing Address - Phone:323-357-6682
Mailing Address - Fax:323-563-8762
Practice Address - Street 1:10300 COMPTON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90002-3628
Practice Address - Country:US
Practice Address - Phone:323-357-6682
Practice Address - Fax:323-563-8762
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA045564207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA45564AOtherMEDI-CAL NUMBER
CAWA45564AOtherMEDI-CAL NUMBER