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General NPI Number Information
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NPI Number | 1699394338
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Entity Type | Individual
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Provider Name | NITIN AGRAWAL MD
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Gender | Male
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 10833 LE CONTE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90095
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Country | US
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Telephone | 310-825-5615
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Fax |
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Provider Business Mailing Address
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Address Line | 15032 CALLE VERANO
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City | CHINO HILLS
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State | CA
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Zip | 91709-5050
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Country | US
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Telephone | 909-664-4111
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A187799
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License Number State | CA
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