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General NPI Number Information
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NPI Number | 1639638968
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Entity Type | Individual
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Provider Name | ANGELA DOAN NP
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Gender | Female
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Dates
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Enumeration Date | 03/16/2019
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Last Update Date | 02/18/2022
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Provider Practice Location Address
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Address Line | 1223 16TH ST STE 3100
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City | SANTA MONICA
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State | CA
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Zip | 90404-1275
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Country | US
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Telephone | 916-221-1792
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 232410
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City | SAN DIEGO
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State | CA
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Zip | 92193-2410
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95009568
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License Number State | CA
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