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General NPI Number Information
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NPI Number | 1528594504
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Entity Type | Individual
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Provider Name | DELILAH ANTIGUA
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Gender | Female
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 1835 S MANCHESTER AVE STE. 108
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City | ANAHEIM
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State | CA
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Zip | 92802-3800
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Country | US
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Telephone | 714-588-2619
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Fax |
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Provider Business Mailing Address
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Address Line | 1835 S MANCHESTER AVE STE. 108
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City | ANAHEIM
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State | CA
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Zip | 92802-3800
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Country | US
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Telephone | 714-588-2619
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | C3747594
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License Number State | CA
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