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General NPI Number Information
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NPI Number | 1780862169
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Entity Type | Individual
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Provider Name | DEBORAH ANGHESOM-NEGUSSE MD
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Gender | Female
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Dates
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Enumeration Date | 02/07/2008
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 8221 ROCHESTER AVE STE 130
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-0721
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Country | US
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Telephone | 909-360-1111
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Fax | 833-989-2428
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Provider Business Mailing Address
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Address Line | 8221 ROCHESTER AVE STE 130
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-0721
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Country | US
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Telephone | 909-360-1111
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Fax | 833-989-2428
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A95164
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License Number State | CA
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