Healthcare Provider Details

I. General information

NPI: 1639863103
Provider Name (Legal Business Name): DALAL AAGO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2023
Last Update Date: 10/27/2026
Certification Date: 10/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5472 EL CAJON BLVD
SAN DIEGO CA
92115-3627
US

IV. Provider business mailing address

5472 EL CAJON BLVD
SAN DIEGO CA
92115-3627
US

V. Phone/Fax

Practice location:
  • Phone: 619-269-0836
  • Fax: 619-269-0906
Mailing address:
  • Phone: 619-269-0836
  • Fax: 619-269-0906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA211021
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: