Individual
DR. ANGELYN MOULTRIE-LIZANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
10251 ARTESIA BLVD, BELLFLOWER, CA 90706-6719
(562) 867-8681
(562) 925-2721
Mailing address
75 REMITTANCE DR DEPT 6008, CHICAGO, IL 60675-6008
(562) 282-1419
(562) 920-4642
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A5603
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX56030
—
CA
01
—
020A56030
BLUE SHIELD
CA
01
—
080179414
RAILROAD MEDICARE
CA
Enumeration date
07/29/2006
Last updated
03/27/2014
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