Healthcare Provider Details

I. General information

NPI: 1982882254
Provider Name (Legal Business Name): AMRIT BHANGOO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 02/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 ELM AVE STE # 210
LONG BEACH CA
90806-1651
US

IV. Provider business mailing address

2650 ELM AVE STE # 210
LONG BEACH CA
90806-1651
US

V. Phone/Fax

Practice location:
  • Phone: 562-595-0166
  • Fax:
Mailing address:
  • Phone: 562-595-0166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberA119707
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: