Healthcare Provider Details

I. General information

NPI: 1821297482
Provider Name (Legal Business Name): ANGEL V DELGADILLO P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15725 WHITTIER BLVD
WHITTIER CA
90603-2347
US

IV. Provider business mailing address

PO BOX 1277
WHITTIER CA
90609-1277
US

V. Phone/Fax

Practice location:
  • Phone: 562-902-5728
  • Fax: 562-943-1090
Mailing address:
  • Phone: 562-906-6470
  • Fax: 562-946-9465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA13449
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: