Organization
CLINCA MEDICA DEL ANGEL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERARDO CANCHOLA MD (MEDICAL DIRECTOR)
(714) 870-1888
Entity
Organization
Contact information
Practice address
1125 W ORANGETHORPE AVE, FULLERTON, CA 92833-4735
(714) 870-1888
Mailing address
1125 W ORANGETHORPE AVE, FULLERTON, CA 92833-4735
(714) 870-1888
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
G55328
CA
Other
Enumeration date
05/08/2012
Last updated
05/08/2012
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