Active NPI
Rajat N Agrawal, MD
- Ophthalmology Physician
- Los Angeles, CA
National Provider Identifier
1306097183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- F 5491
- Practice address
- 1450 San Pablo St
DVRC 124
Los Angeles, CA 90033-4500 - Phone
- (323) 442-6776
- Fax
- (323) 442-6755
- NPI assigned
- Oct 9, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | F 5491 | CA | Primary |
| Ophthalmology Physician | 207W00000X | 2005-00491 | NC |
Addresses
Primary practice location
1450 San Pablo St
DVRC 124
Los Angeles, CA 90033-4500
Mailing address
77 Price St Apt D
Redlands, CA 92373-1427
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F 5491 | CA | MD | Ophthalmology Physician |
| 2005-00491 | NC | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Retina Global | Ophthalmology | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223510400000",
"number": "1306097183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 PRICE ST APT D",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923731427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 SAN PABLO ST",
"address_2": "DVRC 124",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900334500",
"telephone_number": "323-442-6776",
"fax_number": "323-442-6755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGRAWAL",
"first_name": "RAJAT",
"middle_name": "N",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-09",
"last_updated": "2008-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "F 5491",
"primary": true
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NC",
"license": "2005-00491",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.