Provider Demographics
NPI:1700415031
Name:BELANGER, ANN MARIE (DO)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:BELANGER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:
Other - Last Name:BELANGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2433 CENTRAL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4564
Mailing Address - Country:US
Mailing Address - Phone:510-521-2300
Mailing Address - Fax:510-521-7947
Practice Address - Street 1:2433 CENTRAL AVE STE A
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4564
Practice Address - Country:US
Practice Address - Phone:510-521-2300
Practice Address - Fax:510-521-7947
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A20830207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine