Healthcare Provider Details

I. General information

NPI: 1215044888
Provider Name (Legal Business Name): ARUNA KUMARI GARG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 05/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 DURIAN ST STE C
VISTA CA
92083-6240
US

IV. Provider business mailing address

105 DURIAN ST STE A
VISTA CA
92083-6206
US

V. Phone/Fax

Practice location:
  • Phone: 760-724-8562
  • Fax: 760-724-5314
Mailing address:
  • Phone: 760-724-8562
  • Fax: 760-724-5314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberA032844
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: