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General NPI Number Information
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NPI Number | 1477654440
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Entity Type | Individual
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Provider Name | ANGEL GUILLEN PEREZ MEDICAL DOCTOR
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Gender | Male
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 01/14/2008
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Provider Practice Location Address
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Address Line | 1721 N WILMINGTON BLVD
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City | WILMINGTON
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State | CA
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Zip | 90744-1261
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Country | US
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Telephone | 310-835-1414
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Fax | 310-835-4050
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Provider Business Mailing Address
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Address Line | 1459 W TOSCANINI DR
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-1808
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Country | US
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Telephone | 310-521-1865
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G79348
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License Number State | CA
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