Organization
ANGELA M COLOMBO MD INC
Active
Other names
Angela M Colombo, MD Inc
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA M. COLOMBO MD (CEO)
(949) 354-4161
Entity
Organization
Contact information
Practice address
20072 SW BIRCH ST STE 190, NEWPORT BEACH, CA 92660-0799
(949) 354-4161
(833) 667-0260
Mailing address
27762 ANTONIO PKWY STE 325, LADERA RANCH, CA 92694-1140
(949) 235-7735
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
261QC1800X
Corporate Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104474634
—
CA
05
—
1164931341
—
CA
05
—
1780818971
—
CA
05
—
1891974960
—
CA
Enumeration date
08/09/2022
Last updated
10/25/2023
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