NPIMap

Individual provider Active NPI

Jacqueline Balayan Aguiluz, D.O.

  • Family Medicine Physician
  • Hawaiian Gardens, CA
National Provider Identifier
1164572525
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A7451 Issued in CA
Practice address
21508 Norwalk Blvd
Hawaiian Gardens, CA 90716-1122
Phone
(562) 868-0733
NPI assigned
Jan 10, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A7451 CA Primary

Addresses

Primary practice location

21508 Norwalk Blvd
Hawaiian Gardens, CA 90716-1122

Mailing address

21508 Norwalk Blvd
Hawaiian Gardens, CA 90716-1122
Phone (562) 868-0733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050912000813 CA Practitioner - Family Practice 5193638443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jacqueline B Aguiluz D O IncGroup PAC ID 8022040013, 3 clinicians

Practice addresses (Care Compare)

21508 Norwalk Blvd
Hawaiian Gardens, CA 90716-1122
Phone (562) 865-5214

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
7451CAMDAddiction (Substance Use Disorder) Counselor
20A7451CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jacqueline B. Aguiluz, D.O. Inc Family Medicine CurrentSince Nov 6, 2001 Accepting new patients
University of California Irvine Past Accepting new patients
Dignity Health Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients
Coast Plaza Doctors Hospital Past Accepting new patients
Tri-City Hospital Past Accepting new patients
Providence Health System Southern California Past Accepting new patients

Locations

21508 Norwalk Blvd
Hawaiian Gdns, CA 90716
Phone (562) 865-5214

13330 Bloomfield Ave
Ste 111
Norwalk, CA 90650
Phone (562) 868-0733

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1164572525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21508 NORWALK BLVD",
            "city": "HAWAIIAN GARDENS",
            "state": "CA",
            "postal_code": "907161122",
            "telephone_number": "562-868-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21508 NORWALK BLVD",
            "city": "HAWAIIAN GARDENS",
            "state": "CA",
            "postal_code": "907161122",
            "telephone_number": "562-868-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILUZ",
        "first_name": "JACQUELINE",
        "middle_name": "BALAYAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A7451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawaiian Gardens, CA

Sources for this page

Verify at the official NPI Registry.