Provider Demographics
NPI:1073630588
Name:AGRAWAL, BELLA (MD)
Entity Type:Individual
Prefix:DR
First Name:BELLA
Middle Name:
Last Name:AGRAWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 CURTIS WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-3924
Mailing Address - Country:US
Mailing Address - Phone:916-834-7070
Mailing Address - Fax:
Practice Address - Street 1:3635 BRADSHAW RD STE B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-3277
Practice Address - Country:US
Practice Address - Phone:916-368-1500
Practice Address - Fax:916-368-1501
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85202207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GN219AMedicare UPIN