Provider Demographics
NPI:1326024084
Name:AGGARWAL, ARCHANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARCHANA
Middle Name:
Last Name:AGGARWAL
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 1:20055 LAKE CHABOT RD
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5331
Mailing Address - Country:US
Mailing Address - Phone:510-881-1490
Mailing Address - Fax:
Practice Address - Street 1:20055 CASTRO VALLEY ROAD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY 94546
Practice Address - State:CA
Practice Address - Zip Code:94546-2201
Practice Address - Country:US
Practice Address - Phone:510-881-1490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74682207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A746824Medicare PIN