Provider Demographics
NPI:1477828267
Name:GARG, RONAK B (MD)
Entity Type:Individual
Prefix:DR
First Name:RONAK
Middle Name:B
Last Name:GARG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:28319 PLAINFIELD DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-3145
Mailing Address - Country:US
Mailing Address - Phone:310-483-3794
Mailing Address - Fax:323-776-1499
Practice Address - Street 1:28319 PLAINFIELD DR
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-3145
Practice Address - Country:US
Practice Address - Phone:310-483-3794
Practice Address - Fax:323-776-1499
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL000000000207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036133504OtherIDFPR