Provider Demographics
NPI:1487934170
Name:AGUIRRE INSURANCE SERVICES
Entity type:Organization
Organization Name:AGUIRRE INSURANCE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUIRRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-629-5357
Mailing Address - Street 1:PO BOX 74
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95378-0074
Mailing Address - Country:US
Mailing Address - Phone:209-629-5357
Mailing Address - Fax:209-835-5840
Practice Address - Street 1:27133 LILLEGARD CT
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95304-8866
Practice Address - Country:US
Practice Address - Phone:209-629-5357
Practice Address - Fax:209-835-5840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0E20393305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization