MEDICARE: NUESTRA ANGEL MEDICAL CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician
2	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1689625022
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUESTRA ANGEL MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	545 S ALVARADO ST
Second Line	:	SUITE D
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2903
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	545 S ALVARADO ST
Second Line	:	SUITE D
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2903
Country	:	US
Telephone Number	:	213-483-3987
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. ALLAN MING WANG
Credential	:	M.D.
Telephone Number	:	213-483-3987

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	09/11/2025

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