MEDICARE: ASHOK KUMAR AGARWAL M.D., F.A.C.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	A422040	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	330160450	OTHER	CA	TAX ID

General Provider Information

NPI Number	:	1003839838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHOK KUMAR AGARWAL M.D., F.A.C.C.

Provider Business Mailing Address
First Line	:	136 S. SAN JACINTO STREET
Second Line	:
City	:	HEMET
State	:	CA
Zip	:	92543-3097
Country	:	US
Telephone Number	:	951-652-8100
Fax Number	:	951-658-5325

Provider Business Practice Location Address
First Line	:	136 S. SAN JACINTO STREET
Second Line	:
City	:	HEMET
State	:	CA
Zip	:	92543-3097
Country	:	US
Telephone Number	:	951-652-8100
Fax Number	:	951-658-5325

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	04/27/2017

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