Provider Demographics
NPI:1730286683
Name:MOHANTY, SARITA AGGARWAL (MD)
Entity Type:Individual
Prefix:DR
First Name:SARITA
Middle Name:AGGARWAL
Last Name:MOHANTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1200 N STATE ST
Mailing Address - Street 2:ROOM 1110
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90089-1001
Mailing Address - Country:US
Mailing Address - Phone:323-226-2170
Mailing Address - Fax:323-226-5760
Practice Address - Street 1:1200 N STATE ST
Practice Address - Street 2:ROOM 1110
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-1001
Practice Address - Country:US
Practice Address - Phone:323-226-2170
Practice Address - Fax:323-226-5760
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA85227207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW932Medicare ID - Type UnspecifiedHEALTH CENTER
CAW809FMedicare ID - Type UnspecifiedEL MONTE
CAW809AMedicare ID - Type UnspecifiedROYBAL
CAW809BMedicare ID - Type UnspecifiedHUDSON