Gregorio San Valentin Agustin Jr., RN

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

759832 Issued in CA

Practice address

11081 Orchard PL
Garden Grove, CA 92840-3366

Phone

(714) 310-1568

NPI assigned

Oct 18, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1609151901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11081 ORCHARD PL",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928403366",
            "telephone_number": "714-310-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11081 ORCHARD PL",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928403366",
            "telephone_number": "714-310-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUSTIN",
        "first_name": "GREGORIO",
        "middle_name": "SAN VALENTIN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-18",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "759832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF REGISTERED NURSING",
            "identifier": "759832",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marisol Aguirre
• Melanie Stephanie Aguirre
• Mia Aguirre
• Sidney Aguirre
• Agustin Supplies & Services Inc
• Ahcs HIV & Chronic Clinical Care LLC
• Ahcs Specialty Care Garden Grove, LLC
• Ahcs Specialty Care LLC
• Ahcs Specialty Care LLC
• Auva Ahmadi

• Medical-Surgical Registered Nurse in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Medical-Surgical Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; 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.