Healthcare Provider Details

I. General information

NPI: 1235459793
Provider Name (Legal Business Name): POOJA AGGARWAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2010
Last Update Date: 05/14/2020
Certification Date: 05/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 ALHAMBRA BLVD
SACRAMENTO CA
95817-1110
US

IV. Provider business mailing address

637 WESTCHESTER DR
FOLSOM CA
95630-6250
US

V. Phone/Fax

Practice location:
  • Phone: 916-737-5555
  • Fax: 916-436-5559
Mailing address:
  • Phone: 605-595-7301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA138601
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: