Provider Demographics
NPI:1508957895
Name:BUFFENN, ANGELA NOVELA (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:NOVELA
Last Name:BUFFENN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6430 W SUNSET BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7901
Mailing Address - Country:US
Mailing Address - Phone:323-361-2337
Mailing Address - Fax:323-361-8491
Practice Address - Street 1:4650 W SUNSET BLVD
Practice Address - Street 2:MS# 88
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:323-361-2344
Practice Address - Fax:323-361-6283
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2012-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA76397207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A763970 G73OtherCAL OPTIMA
CA00A763970Medicaid
CA00A763970Medicaid
CAG94615Medicare UPIN