Provider Demographics
NPI:1396003257
Name:AGRAWAL, TISHANGI KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:TISHANGI
Middle Name:KUMAR
Last Name:AGRAWAL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:300 WHISPERING PINES DR
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-2400
Mailing Address - Country:US
Mailing Address - Phone:626-898-9858
Mailing Address - Fax:626-898-4749
Practice Address - Street 1:1202 E GREEN ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-3112
Practice Address - Country:US
Practice Address - Phone:626-898-9858
Practice Address - Fax:626-898-4749
Is Sole Proprietor?:No
Enumeration Date:2012-04-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA139580207RC0000X, 207RG0300X, 207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA139580OtherMEDICAL LISCENSE