Provider Demographics
NPI:1255846358
Name:SAMBRANO, ANGELA (CMF)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:SAMBRANO
Suffix:
Gender:F
Credentials:CMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 W CARSON ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-3909
Mailing Address - Country:US
Mailing Address - Phone:310-320-5777
Mailing Address - Fax:310-320-6341
Practice Address - Street 1:1319 W CARSON ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-3909
Practice Address - Country:US
Practice Address - Phone:310-320-5777
Practice Address - Fax:310-320-6341
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-12
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00318224900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy FitterGroup - Single Specialty