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General NPI Number Information
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NPI Number | 1043766363
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Entity Type | Individual
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Provider Name | AMBER JOY RANGEL PA-C, MPAP
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Gender | Female
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 06/01/2022
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Provider Practice Location Address
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Address Line | 2990 S SEPULVEDA BLVD # 300
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City | LOS ANGELES
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State | CA
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Zip | 90064-0002
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Country | US
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Telephone | 323-421-4747
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 642292 11270 EXPOSITION BLVD FL 1
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City | LOS ANGELES
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State | CA
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Zip | 90064
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Country | US
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Telephone | 310-999-9592
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 53556
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License Number State | CA
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