Healthcare Provider Details

I. General information

NPI: 1891633772
Provider Name (Legal Business Name): ANGELMAE E AWANG MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3939 ATLANTIC AVE STE 102
LONG BEACH CA
90807-3535
US

IV. Provider business mailing address

15329 GARD AVE
NORWALK CA
90650-6340
US

V. Phone/Fax

Practice location:
  • Phone: 562-304-9592
  • Fax:
Mailing address:
  • Phone: 562-584-3857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: