Provider Demographics
NPI:1316577927
Name:ANGELUS GROUPS, INC.
Entity Type:Organization
Organization Name:ANGELUS GROUPS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:YOUNG TAE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:213-434-4593
Mailing Address - Street 1:903 CRENSHAW BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-1965
Mailing Address - Country:US
Mailing Address - Phone:213-247-5520
Mailing Address - Fax:
Practice Address - Street 1:903 CRENSHAW BLVD STE 101
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-1965
Practice Address - Country:US
Practice Address - Phone:213-247-5520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty