Provider Demographics
NPI:1003192576
Name:BURWICK, ANGELA F (LM, CPM)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:F
Last Name:BURWICK
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 N CLAREMONT BLVD
Mailing Address - Street 2:SUITE 207-B
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-3528
Mailing Address - Country:US
Mailing Address - Phone:909-641-4161
Mailing Address - Fax:
Practice Address - Street 1:1420 N CLAREMONT BLVD
Practice Address - Street 2:SUITE 207-B
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-3528
Practice Address - Country:US
Practice Address - Phone:909-641-4161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA320176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife