=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699398016
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSHUA BENJAMIN ANG DO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/20/2020
-----------------------------------------------------
Last Update Date | 07/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 94 N MADISON AVE
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91101-1740
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-858-2071
-----------------------------------------------------
Fax | 626-792-2328
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 94 N MADISON AVE
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91101-1740
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-858-2071
-----------------------------------------------------
Fax | 626-792-2328
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207K00000X
-----------------------------------------------------
Taxonomy Name | Allergy & Immunology Physician
-----------------------------------------------------
License Number | 20A23828
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------