Healthcare Provider Details

I. General information

NPI: 1205371390
Provider Name (Legal Business Name): ATUL AGGARWAL MD CARDIOLOGY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2016
Last Update Date: 12/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 STOCKDALE HWY #200
BAKERSFIELD CA
93311-3614
US

IV. Provider business mailing address

9330 STOCKDALE HWY #200
BAKERSFIELD CA
93311-3614
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number95004556
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95004556
License Number StateCA

VIII. Authorized Official

Name: DR. ATUL AGGARWAL
Title or Position: MD
Credential: MD
Phone: 661-664-0100