Provider Demographics
NPI:1275632887
Name:AGARWAL, DIMPLE (MD)
Entity Type:Individual
Prefix:DR
First Name:DIMPLE
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 1:1180 N INDIAN CANYON DR
Mailing Address - Street 2:SUITE E420
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4800
Mailing Address - Country:US
Mailing Address - Phone:760-778-7147
Mailing Address - Fax:760-341-9966
Practice Address - Street 1:1180 N INDIAN CANYON DR
Practice Address - Street 2:STE E-317
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4800
Practice Address - Country:US
Practice Address - Phone:760-778-7147
Practice Address - Fax:760-416-5023
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA066261207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH51589Medicare UPIN
CA00A662610Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER