| Valley Infant Pediatric & Complete Family Care | |
|
1363 W Avenue J Lancaster CA 93534-2935 | |
| (661) 726-5000 | |
| (661) 726-4347 |
| Full Name | Valley Infant Pediatric & Complete Family Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 1363 W Avenue J, Lancaster, California |
| Authorized Official Name and Position | Hari P. Agarwal (PRESIDENT) |
| Authorized Official Contact | 6617265000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Infant Pediatric & Complete Family Care 1359 W Avenue J Lancaster CA 93534-2935 Ph: (661) 726-5000 | Valley Infant Pediatric & Complete Family Care 1363 W Avenue J Lancaster CA 93534-2935 Ph: (661) 726-5000 |
| NPI Number | 1528083383 |
|---|---|
| Provider Enumeration Date | 07/13/2006 |
| Last Update Date | 10/19/2021 |
| Medicare PECOS PAC ID | 0446297238 |
|---|---|
| Medicare Enrollment ID | O20050413000575 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528083383 | NPI | - | NPPES |
| 110132636 | Other | CA | RR MCARE DR CHHAYA INDIV |
| 00G462460 | Medicaid | CA | |
| CD2403 | Other | CA | RR MEDICARE GROUP # |
| 05D0725255 | Other | CA | CLIA |
| G462460 | Other | CA | MEDICAL LICENSE DR HARI |
| GR0079280 | Medicaid | CA | |
| ZZZ64543Z | Other | CA | BLUE SHIELD GROUP ID# |
| 110132635 | Other | CA | RR MCARE DR HARI INDIVIDU |
| A455310 | Other | CA | MEDICAL LICENSE DR CHHAYA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G462460 (California) | Secondary |
| 207R00000X | Internal Medicine | G462460 (California) | Primary |
| 208000000X | Pediatrics | A455310 (California) | Secondary |
| Provider Name | Harihar P Agarwal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215964150 PECOS PAC ID: 4981641776 Enrollment ID: I20080422000934 |
| Provider Name | Tiffany J L'roy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083099188 PECOS PAC ID: 4082921226 Enrollment ID: I20190318001955 |
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