Provider Demographics
NPI:1679512289
Name:CORBETT, AARON
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:
Last Name:CORBETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 HARMONY PL
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-2231
Mailing Address - Country:US
Mailing Address - Phone:818-957-3957
Mailing Address - Fax:818-957-3958
Practice Address - Street 1:2445 HARMONY PL
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-2231
Practice Address - Country:US
Practice Address - Phone:818-957-3957
Practice Address - Fax:818-957-3958
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography
No246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG102Medicare PIN