Provider Demographics
NPI:1588609382
Name:ALLEVATO, ANGELA (MD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:ALLEVATO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:ALLEVATO
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:431 S BATAVIA ST
Mailing Address - Street 2:#203
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3936
Mailing Address - Country:US
Mailing Address - Phone:714-639-0662
Mailing Address - Fax:714-639-0660
Practice Address - Street 1:431 S BATAVIA ST
Practice Address - Street 2:#203
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3936
Practice Address - Country:US
Practice Address - Phone:714-639-0662
Practice Address - Fax:714-639-0660
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG072682208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics