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1891974960 NPI number — ANGELA MARIA COLOMBO M.D.

NPI Number: 1891974960
Health Care Provider/Practitioner: ANGELA MARIA COLOMBO M.D.

Information about “1891974960” NPI (ANGELA MARIA COLOMBO M.D.) exists in 1891974960 in HTML format HTML  |  1891974960 in plain Text format TXT  |  1891974960 in PDF (Portable Document Format) PDF  |  1891974960 in an XML format XML  formats.

NPI Number : 1891974960 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1891974960",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "COLOMBO",
    "FirstName": "ANGELA",
    "MiddleName": "MARIA",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GRAMMAS",
    "OtherFirstName": "ANGELA",
    "OtherMiddleName": "MARIA",
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "27762 ANTONIO PKWY L1 #325",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LADERA RANCH",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92694-1247",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "949-235-8835",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "20072 SW BIRCH ST STE 190",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEWPORT BEACH",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92660-0799",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "949-354-4161",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/25/2007",
    "LastUpdateDate": "02/11/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "A73564",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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