Provider Demographics
NPI:1629421755
Name:KAO, ANGELA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:KAO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80B VETERANS BLVD
Mailing Address - Street 2:
Mailing Address - City:ACOMA
Mailing Address - State:NM
Mailing Address - Zip Code:87034
Mailing Address - Country:US
Mailing Address - Phone:505-552-5394
Mailing Address - Fax:505-552-5464
Practice Address - Street 1:80B VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:ACOMA
Practice Address - State:NM
Practice Address - Zip Code:87034
Practice Address - Country:US
Practice Address - Phone:505-552-5394
Practice Address - Fax:505-552-5464
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist