Healthcare Provider Details

I. General information

NPI: 1568136596
Provider Name (Legal Business Name): DARSHANA VIJAYWARGIYA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2021
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 SAN PABLO ST STE 3000
LOS ANGELES CA
90033-5315
US

IV. Provider business mailing address

PO BOX 50938
LOS ANGELES CA
90074-0938
US

V. Phone/Fax

Practice location:
  • Phone: 323-442-5710
  • Fax:
Mailing address:
  • Phone: 323-442-5710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA202549
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: