Provider Demographics
NPI:1720045412
Name:ANGLE, NIREN (MD)
Entity Type:Individual
Prefix:DR
First Name:NIREN
Middle Name:
Last Name:ANGLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 EL CAPITAN DR
Mailing Address - Street 2:STE 120
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-6260
Mailing Address - Country:US
Mailing Address - Phone:925-239-2549
Mailing Address - Fax:
Practice Address - Street 1:24411 HEALTH CENTER DR
Practice Address - Street 2:SUITE 350
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3651
Practice Address - Country:US
Practice Address - Phone:949-457-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG78968208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G789680Medicaid
CAH39992Medicare UPIN
CA00G789680Medicaid