Provider Demographics
NPI:1508848292
Name:TANGCO, ANGELITA DINEROS (MD)
Entity Type:Individual
Prefix:
First Name:ANGELITA
Middle Name:DINEROS
Last Name:TANGCO
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2220 GLADSTONE DR
Mailing Address - Street 2:SUITE 3 SPRINGHILL MEDICAL GROUP
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-5123
Mailing Address - Country:US
Mailing Address - Phone:925-432-3118
Mailing Address - Fax:925-432-4590
Practice Address - Street 1:2220 GLADSTONE DR
Practice Address - Street 2:SUITE 3 SPRINGHILL MEDICAL GROUP
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-5123
Practice Address - Country:US
Practice Address - Phone:925-432-3118
Practice Address - Fax:925-432-4590
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK74012084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX042833601Medicaid
TX042833601Medicaid
TX84056KMedicare ID - Type Unspecified