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General NPI Number Information
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NPI Number | 1659756849
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Entity Type | Individual
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Provider Name | JILLIAN ANGELO MD
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Gender | Female
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Dates
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Enumeration Date | 07/29/2015
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 21250 HAWTHORNE BLVD STE 430
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City | TORRANCE
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State | CA
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Zip | 90503-5511
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Country | US
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Telephone | 310-326-3066
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Fax | 310-326-3068
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Provider Business Mailing Address
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Address Line | 21250 HAWTHORNE BLVD STE 430
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City | TORRANCE
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State | CA
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Zip | 90503-5511
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Country | US
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Telephone | 310-326-3066
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Fax | 310-326-3068
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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 | A146626
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License Number State | CA
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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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