Provider Demographics
NPI:1992751937
Name:DUGGAL, ARUN (MD)
Entity type:Individual
Prefix:
First Name:ARUN
Middle Name:
Last Name:DUGGAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 SPANOS CT
Mailing Address - Street 2:SUITE #205
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-2810
Mailing Address - Country:US
Mailing Address - Phone:209-525-3199
Mailing Address - Fax:209-525-3802
Practice Address - Street 1:1401 SPANOS CT STE 205
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-2813
Practice Address - Country:US
Practice Address - Phone:209-525-3199
Practice Address - Fax:209-525-3802
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42295207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A422951Medicaid
CA00A422951Medicaid
CAA29549Medicare UPIN