Provider Demographics
NPI:1275519845
Name:ANGAROLA, JEFF (DPM)
Entity Type:Individual
Prefix:DR
First Name:JEFF
Middle Name:
Last Name:ANGAROLA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3828 SCHAUFELE AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1793
Mailing Address - Country:US
Mailing Address - Phone:714-665-1600
Mailing Address - Fax:
Practice Address - Street 1:30300 RANCHO VIEJO RD
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-1576
Practice Address - Country:US
Practice Address - Phone:949-661-9600
Practice Address - Fax:949-443-6200
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3437208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT19328Medicare UPIN
CAEN720ZMedicare PIN
CAWE3437KMedicare PIN
CAWE3437JMedicare PIN