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Individual
MATTHEW DEANGELIS
Active
Individual
MATTHEW DEANGELIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
633583
CA
363LX0106X
Occupational Health Nurse Practitioner
Primary
21084
CA
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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