Basic Information
Provider Information
NPI: 1336336411
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AGGARWAL
FirstName: SONAL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: DEPT 34929
Address2: P.O. BOX 39000
City: SAN FRANCISCO
State: CA
PostalCode: 941390001
CountryCode: US
TelephoneNumber: 9259522828
FaxNumber: 9259522850
Practice Location
Address1: 1450 TREAT BLVD
Address2: SUITE 160
City: WALNUT CREEK
State: CA
PostalCode: 945972168
CountryCode: US
TelephoneNumber: 9252969000
FaxNumber: 9252969071
Other Information
ProviderEnumerationDate: 10/02/2007
LastUpdateDate: 06/26/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XA101426CAY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
P0145150201CARAILROAD MEDICAREOTHER


Home