Provider Demographics
NPI:1508870700
Name:GARG, YOGENDER PAL (MD)
Entity Type:Individual
Prefix:
First Name:YOGENDER
Middle Name:PAL
Last Name:GARG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 OUTLET CENTER DR
Mailing Address - Street 2:STE 240
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-0663
Mailing Address - Country:US
Mailing Address - Phone:805-981-6300
Mailing Address - Fax:805-981-6330
Practice Address - Street 1:1901 OUTLET CENTER DR
Practice Address - Street 2:STE 240
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-0663
Practice Address - Country:US
Practice Address - Phone:805-981-6300
Practice Address - Fax:805-981-6330
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66071207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A660710Medicaid
CAW18921Medicare ID - Type Unspecified
CA00A660710Medicaid