Provider Demographics
NPI:1467400192
Name:LP ANGEL MEDICAL CENTER, A PROF. CORP.
Entity Type:Organization
Organization Name:LP ANGEL MEDICAL CENTER, A PROF. CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HYUNG
Authorized Official - Middle Name:WON
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-229-9892
Mailing Address - Street 1:3111 W ORANGE AVE
Mailing Address - Street 2:120
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3153
Mailing Address - Country:US
Mailing Address - Phone:714-229-9892
Mailing Address - Fax:714-229-9682
Practice Address - Street 1:3111 W ORANGE AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3153
Practice Address - Country:US
Practice Address - Phone:714-229-9892
Practice Address - Fax:714-229-9682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty