MEDICARE: ANGELITA S BEREDO MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255471959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELITA S BEREDO MD INC

Provider Business Mailing Address
First Line	:	4220 MICHELLE DR
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90503-2413
Country	:	US
Telephone Number	:	310-671-2699
Fax Number	:	310-671-6541

Provider Business Practice Location Address
First Line	:	301 N PRAIRIE AVE
Second Line	:	SUITE 301
City	:	INGLEWOOD
State	:	CA
Zip	:	90301-4507
Country	:	US
Telephone Number	:	310-671-2699
Fax Number	:	310-671-6541

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ANGELITA S BEREDO
Credential	:	MD
Telephone Number	:	310-671-2699

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	08/22/2020

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Directions to “ANGELITA S BEREDO MD INC ” Practice Location

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