Provider Demographics
NPI:1134124548
Name:AGARWAL, VANDANA (MD)
Entity Type:Individual
Prefix:DR
First Name:VANDANA
Middle Name:
Last Name:AGARWAL
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 1:350 VINTON AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-3000
Mailing Address - Country:US
Mailing Address - Phone:909-620-5502
Mailing Address - Fax:909-629-0552
Practice Address - Street 1:350 VINTON AVE
Practice Address - Street 2:STE 101
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3000
Practice Address - Country:US
Practice Address - Phone:909-620-5502
Practice Address - Fax:909-629-0552
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41760207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology