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General NPI Number Information
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NPI Number | 1861113508
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Entity Type | Individual
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Provider Name | JONATHAN A ANG
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Gender | Male
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 10/16/2022
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Provider Practice Location Address
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Address Line | 28150 KELLER RD
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City | MURRIETA
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State | CA
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Zip | 92563-2432
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Country | US
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Telephone | 833-574-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 8760 HUNT CANYON RD
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City | CORONA
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State | CA
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Zip | 92883-9274
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Country | US
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Telephone | 951-543-1844
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 86580
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License Number State | CA
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