Provider Demographics
NPI:1386821569
Name:BELLI-MOJICA, ANGELO R (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:R
Last Name:BELLI-MOJICA
Suffix:
Gender:M
Credentials:MD, MPH
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Other - Credentials:
Mailing Address - Street 1:110 MARY AVE.
Mailing Address - Street 2:UNIT #2-195
Mailing Address - City:NIPOMO
Mailing Address - State:CA
Mailing Address - Zip Code:93444
Mailing Address - Country:US
Mailing Address - Phone:805-468-2000
Mailing Address - Fax:
Practice Address - Street 1:10333 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-5808
Practice Address - Country:US
Practice Address - Phone:805-468-2188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ42541207Q00000X
CAA120630207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine