Provider Demographics
NPI:1619187978
Name:ANGELES IPA, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ANGELES IPA, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NARCISO
Authorized Official - Middle Name:
Authorized Official - Last Name:AZURIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-947-8600
Mailing Address - Street 1:P.O. BOX 6300
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-0063
Mailing Address - Country:US
Mailing Address - Phone:714-947-8600
Mailing Address - Fax:
Practice Address - Street 1:5785 CORPORATE AVE.
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-4726
Practice Address - Country:US
Practice Address - Phone:714-947-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty