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General NPI Number Information
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NPI Number | 1528160777
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Entity Type | Individual
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Provider Name | VIVEK KUMAR AGRAWAL MD
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Gender | Male
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 105 N BASCOM AVE STE 104
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City | SAN JOSE
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State | CA
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Zip | 95128-1811
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Country | US
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Telephone | 408-918-0405
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Fax | 408-918-0409
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Provider Business Mailing Address
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Address Line | 13345 ILLINOIS ST
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City | CARMEL
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State | IN
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Zip | 46032-3318
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Country | US
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Telephone | 317-396-1300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 246327
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A98462
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 01063473A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD444582
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | M9778
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2006001569
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License Number State | MO
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Taxonomy #7
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | MD444582
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License Number State | PA
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