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General NPI Number Information
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NPI Number | 1861547093
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Entity Type | Individual
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Provider Name | ANGIE GOROSPE PT
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Gender | Female
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 02/15/2010
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Provider Practice Location Address
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Address Line | 2701 CALLOWAY DR # 400
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City | BAKERSFIELD
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State | CA
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Zip | 93312-2621
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Country | US
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Telephone | 661-589-9066
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Fax | 661-589-4209
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Provider Business Mailing Address
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Address Line | 1201 23RD ST
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City | BAKERSFIELD
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State | CA
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Zip | 93301-2306
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Country | US
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Telephone | 661-327-4357
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Fax | 661-327-2311
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | PT32659
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License Number State | CA
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