Eduardo Ajuria, MD

Individual provider Active NPI Family Medicine Physician · Baldwin Park, CA

NPI 1104997097 · NPPES record last updated Sep 23, 2008

Key facts

NPI
1104997097
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
G40046 (CA)
Practice address
1011 Baldwin Park Blvd
Baldwin Park, CA 91706-5806
Phone
(626) 851-1011
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G40046CAMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G40046 CA Yes

Addresses

Primary practice location

1011 Baldwin Park Blvd
Baldwin Park, CA 91706-5806

Mailing address

1011 Baldwin Park Blvd
Baldwin Park, CA 91706-5806
Phone (626) 851-1011

Other providers in Baldwin Park, CA

All providers in Baldwin Park, CA · Family Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.