Provider Demographics
NPI:1316209935
Name:NIROG MEDICAL INC
Entity Type:Organization
Organization Name:NIROG MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHWETA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-249-6600
Mailing Address - Street 1:6001 TRUXTUN AVE
Mailing Address - Street 2:BLDG A, SUITE 180
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0679
Mailing Address - Country:US
Mailing Address - Phone:661-249-6600
Mailing Address - Fax:661-249-6877
Practice Address - Street 1:6001 TRUXTUN AVE
Practice Address - Street 2:SUITE 180-A
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0679
Practice Address - Country:US
Practice Address - Phone:661-249-6600
Practice Address - Fax:661-249-6877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-11
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98555207Q00000X, 208D00000X
CAA99233207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty