Healthcare Provider Details

I. General information

NPI: 1043622442
Provider Name (Legal Business Name): ANGEL MANAHEL PAULS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 EUCLID AVE. SUITE 225 282 EUCLID AVE. SUITE 225
SAN DIEGO CA
92114
US

IV. Provider business mailing address

5473 KEARNY VILLA RD
SAN DIEGO CA
92123-1150
US

V. Phone/Fax

Practice location:
  • Phone: 619-521-9569
  • Fax:
Mailing address:
  • Phone: 619-521-9569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: