Individual
EMMANUEL S ANGELES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
33758 YUCAIPA BLVD, YUCAIPA, CA 92399-2243
(909) 795-9747
(909) 797-1191
Mailing address
PO BOX 10069, SAN BERNARDINO, CA 92423-0069
(909) 335-4188
(909) 335-4158
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5816
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ39731Z
—
CA
Enumeration date
05/24/2006
Last updated
04/06/2015
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