Organization
ANGEL FAMILY PRACTICE MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHENDRA G SANATHRA M.D. (PRESIDENT)
(323) 581-0000
Entity
Organization
Contact information
Practice address
2015 E FLORENCE AVE, LOS ANGELES, CA 90001-2754
(323) 581-0000
(323) 585-4030
Mailing address
5340 LA FIESTA, YORBA LINDA, CA 92887-4009
(714) 692-5775
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A50182
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A501821
MEDICAL PROVIDER NUMBER
CA
Enumeration date
11/01/2006
Last updated
02/24/2012
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