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Individual

ANGIE GOROSPE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
2701 CALLOWAY DR, # 400, BAKERSFIELD, CA 93312-2621
(661) 589-9066
(661) 589-4209
Mailing address
1201 23RD ST, BAKERSFIELD, CA 93301-2306
(661) 327-4357
(661) 327-2311

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT32659
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0PT326590
MEDICARE PTAN
CA
01
P00711450
RAILROAD MEDICARE PTAN
CA
01
ZZZ21295Z
MEDICARE GROUP PTAN
CA
Enumeration date
01/25/2007
Last updated
02/15/2010
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