# ANGEL FAMILY PRACTICE MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134206436
- **Authorized official:** MAHENDRA G SANATHRA M.D. (PRESIDENT)
- **Authorized official phone:** (323) 581-0000

## Contact information

- **Practice address:** 2015 E FLORENCE AVE, LOS ANGELES, CA 90001-2754
- **Practice address phone:** (323) 581-0000
- **Practice address fax:** (323) 585-4030
- **Mailing address:** 5340 LA FIESTA, YORBA LINDA, CA 92887-4009
- **Mailing address phone:** (714) 692-5775

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A50182 | CA | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 02/24/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00A501821 | MEDICAL PROVIDER NUMBER | CA |