Sonal Agrawal, M.D.
Individual provider Active NPI Pediatrics Physician · La Mesa, CA
NPI 1881702348 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1881702348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- A73087 (CA)
- Practice address
- 5525 Grossmont Center Dr
La Mesa, CA 91942-3009 - Phone
- (858) 499-2600
- NPI assigned
- Aug 26, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040128000911 | CA | Practitioner - Pediatric Medicine | 3072416023 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A73087 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sharp Rees-Stealy Medical Group, Inc | Pediatrics | Current |
Accepting new patients |
| Sharp Rees-Stealy Medical Group, Inc | Current |
Accepting new patients | |
| Sharp Memorial Hospital | Past | Accepting new patients | |
| Sharp Rees-Stealy Medical Center | Past | Accepting new patients |
Locations
5525 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 644-6600
2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500
10243 Genetic Center Dr
San Diego, CA 92121
Phone (858) 499-2704
Interoperability endpoints
- sagrawal64518@sharphealthcare.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A73087 | CA | Yes |
Addresses
Primary practice location
5525 Grossmont Center Dr
La Mesa, CA 91942-3009
Mailing address
5525 Grossmont Center Dr
La Mesa, CA 91942-3009
Phone (858) 499-2600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A730870 | Medicaid | CA |
Other providers in La Mesa, CA
- Aesthetic Arts Institute of Plastic Surgery, LLC
- Aethetic Arts Institute of Plastic Surgery,LLC
- Alicia A Afrah-Boateng
- Payam Afshar
- Ag la Mesa, LLC
- Itzel Aguirre
- Malaz Ahmed
- Nida Ahmed
- Wadie Nabih Ahwal
- Joseph P Aiello
All providers in La Mesa, CA · Pediatrics Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.