Healthcare Provider Details

I. General information

NPI: 1275214280
Provider Name (Legal Business Name): ANGIE K OH ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 W OLYMPIC BLVD STE 225
LOS ANGELES CA
90006-2368
US

IV. Provider business mailing address

3250 W OLYMPIC BLVD STE 225
LOS ANGELES CA
90006-2368
US

V. Phone/Fax

Practice location:
  • Phone: 323-730-8880
  • Fax:
Mailing address:
  • Phone: 323-730-8880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: