Individual
JOAN LUCILE KING-ANGELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3260 SACRAMENTO ST, OVER 60 CLINIC, BERKELEY, CA 94702
(510) 274-8996
(510) 981-4191
Mailing address
2344 - 6TH ST, BERKELEY, CA 94710
(510) 981-3203
(510) 981-4191
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
G58410
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G584100
—
CA
Enumeration date
11/01/2006
Last updated
09/12/2014
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