Provider Demographics
NPI:1811230766
Name:AGARWAL, DANIEL RAHUL (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:RAHUL
Last Name:AGARWAL
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 1:689 TANK FARM RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-7078
Mailing Address - Country:US
Mailing Address - Phone:805-781-3937
Mailing Address - Fax:805-648-7027
Practice Address - Street 1:689 TANK FARM RD
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7077
Practice Address - Country:US
Practice Address - Phone:805-781-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.130547207W00000X
CT60486207W00000X
390200000X
CAA168859207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program