Healthcare Provider Details

I. General information

NPI: 1376891374
Provider Name (Legal Business Name): ATUL AGGARWAL MD CARDIOLOGY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2012
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 STOCKDALE HWY STE 200
BAKERSFIELD CA
93311-3614
US

IV. Provider business mailing address

PO BOX 10898
BAKERSFIELD CA
93389-0898
US

V. Phone/Fax

Practice location:
  • Phone: 661-664-0100
  • Fax: 661-664-0111
Mailing address:
  • Phone: 661-664-0100
  • Fax: 661-664-0111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC53451
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberC53451
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberC53451
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberC53451
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberC53451
License Number StateCA

VIII. Authorized Official

Name: ATUL AGGARWAL
Title or Position: MD/OWNER
Credential: MD
Phone: 661-869-2600