Provider Demographics
NPI:1013362946
Name:ANGELES, CLARA EMILIA (MD)
Entity Type:Individual
Prefix:DR
First Name:CLARA
Middle Name:EMILIA
Last Name:ANGELES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CLARA
Other - Middle Name:EMILIA
Other - Last Name:FRIAS-TAVERAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:600 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53792-7375
Mailing Address - Country:US
Mailing Address - Phone:608-890-0554
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-7375
Practice Address - Country:US
Practice Address - Phone:608-890-0554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI76953-20208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery