Provider Demographics
NPI:1629045372
Name:ARGENAL, AGUSTIN JOHN (MD)
Entity type:Individual
Prefix:
First Name:AGUSTIN
Middle Name:JOHN
Last Name:ARGENAL
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 1:1450 TREAT BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-2168
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2485 HIGH SCHOOL AVE
Practice Address - Street 2:STE 100
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1819
Practice Address - Country:US
Practice Address - Phone:925-671-0610
Practice Address - Fax:925-671-0878
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG33520207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG33520OtherLICENSE
CACA189420Medicare PIN
CAG33520OtherLICENSE
CA00G335201Medicare ID - Type UnspecifiedPPIN