Individual provider Active NPI

Andre Mikhail Frijus Aguilar

  • Physical Therapy Assistant
  • San Diego, CA
National Provider Identifier
1346106697
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
54394 Issued in CA
Practice address
2727 Camino del Rio S Ste 102
San Diego, CA 92108-3797
Phone
(858) 452-0282
NPI assigned
Dec 30, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 54394 CA Primary

Addresses

Primary practice location

2727 Camino del Rio S Ste 102
San Diego, CA 92108-3797

Mailing address

3722 Conrad Ave
San Diego, CA 92117-1807
Phone (619) 876-3973

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
54394CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Functionsmart CurrentSince Jan 4, 2026 Accepting new patients
Developmental Therapy Center PastSince Jan 4, 2026 Accepting new patients

Locations

2727 Camino del Rio S
Ste 102
San Diego, CA 92108
Phone (858) 452-0282

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1767052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1346106697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3722 CONRAD AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921171807",
            "telephone_number": "619-876-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 CAMINO DEL RIO S STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083797",
            "telephone_number": "858-452-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILAR",
        "first_name": "ANDRE",
        "middle_name": "MIKHAIL FRIJUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-30",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "54394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.