Provider Demographics
NPI:1598792459
Name:AGARWAL, CHHAYA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHHAYA
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 1:1359 W AVENUE J
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2935
Mailing Address - Country:US
Mailing Address - Phone:661-726-5000
Mailing Address - Fax:661-726-4347
Practice Address - Street 1:1359 W AVENUE J
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2935
Practice Address - Country:US
Practice Address - Phone:661-726-5000
Practice Address - Fax:661-726-4347
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45531208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0079280OtherMEDICAL GROUP
CA00A455310Medicaid
CABA1490135OtherDEA
CA00A455310Medicaid
CAW13599Medicare ID - Type Unspecified