Healthcare Provider Details

I. General information

NPI: 1437339637
Provider Name (Legal Business Name): ANGELA DESAI N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1673 W BROADWAY STE 6
ANAHEIM CA
92802-1109
US

IV. Provider business mailing address

28541 KALMIA AVE
MORENO VALLEY CA
92555-6521
US

V. Phone/Fax

Practice location:
  • Phone: 714-774-5915
  • Fax: 714-774-8095
Mailing address:
  • Phone: 951-538-8508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number475289
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: