Healthcare Provider Details

I. General information

NPI: 1790464170
Provider Name (Legal Business Name): ANGELA MARIA FRANCO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2023
Last Update Date: 11/09/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 CENTURY PARK E STE 1407
LOS ANGELES CA
90067-2017
US

IV. Provider business mailing address

2501 S WEST VIEW ST APT 205
LOS ANGELES CA
90016-2868
US

V. Phone/Fax

Practice location:
  • Phone: 310-277-2929
  • Fax:
Mailing address:
  • Phone: 401-359-0757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number63034
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number63034
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number63034
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: