Provider Demographics
NPI:1073544714
Name:THE ANGELES CLINIC AND RESEARCH INSTITUTE, INC.
Entity Type:Organization
Organization Name:THE ANGELES CLINIC AND RESEARCH INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NANAZ
Authorized Official - Middle Name:F
Authorized Official - Last Name:AMINI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:310-231-2180
Mailing Address - Street 1:11818 WILSHIRE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-6647
Mailing Address - Country:US
Mailing Address - Phone:310-231-2121
Mailing Address - Fax:310-496-0679
Practice Address - Street 1:11818 WILSHIRE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6647
Practice Address - Country:US
Practice Address - Phone:310-231-2121
Practice Address - Fax:310-496-0679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & TherapyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW15185OtherMEDICARE PTAN - FACILITY
CAW15185AOtherMEDICARE PTAN - FACILITY
CAF04057Medicare UPIN
CAA52182Medicare UPIN
CAA40998Medicare UPIN
CAWG20643DMedicare PIN
CAE87688Medicare UPIN
CAWA82669AMedicare PIN
CAWG45466CMedicare PIN
CAW15185OtherMEDICARE PTAN - FACILITY
CAB45772Medicare UPIN
CAI33167Medicare UPIN
CAWA74223BMedicare PIN
CAW15185AOtherMEDICARE PTAN - FACILITY
CAG71321Medicare UPIN
CAI57646Medicare UPIN
CAA46556Medicare UPIN
CAWA67979AMedicare PIN
CAA89817Medicare UPIN
CA4582760002Medicare NSC
CAWG36051KMedicare PIN
CAWA53519BMedicare PIN
CAW20A6503BMedicare PIN