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General NPI Number Information
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NPI Number | 1780380162
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Entity Type | Individual
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Provider Name | ANGIE MICHELLE CIFUENTES
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Gender | Female
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Dates
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Enumeration Date | 02/06/2023
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 4477 W 118TH ST STE 502
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City | HAWTHORNE
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State | CA
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Zip | 90250-2260
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Country | US
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Telephone | 213-600-0472
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Fax |
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Provider Business Mailing Address
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Address Line | 4038 W 133RD ST APT A
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City | HAWTHORNE
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State | CA
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Zip | 90250-5979
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Country | US
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Telephone | 310-343-1763
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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 | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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