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General NPI Number Information
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NPI Number | 1013159912
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Entity Type | Individual
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Provider Name | CARLOS MANUEL ANGELES SAN MATEO MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2009
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 455 OCONNOR DR STE 270
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City | SAN JOSE
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State | CA
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Zip | 95128-1644
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Country | US
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Telephone | 415-939-0928
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Fax |
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Provider Business Mailing Address
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Address Line | 455 OCONNOR DR STE 270
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City | SAN JOSE
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State | CA
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Zip | 95128-1644
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Country | US
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Telephone | 408-707-1410
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Fax | 866-531-9599
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME125705
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A137904
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License Number State | CA
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