Healthcare Provider Details

I. General information

NPI: 1528361540
Provider Name (Legal Business Name): ARUNIMA AGARWAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2010
Last Update Date: 02/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 MADERA RD
SIMI VALLEY CA
93065-3053
US

IV. Provider business mailing address

1040 FLYNN RD
CAMARILLO CA
93012-5092
US

V. Phone/Fax

Practice location:
  • Phone: 805-552-5722
  • Fax: 805-915-4401
Mailing address:
  • Phone: 805-673-3930
  • Fax: 805-659-3217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA121134
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: