Provider Demographics
NPI:1760552160
Name:ABERG, ANGELA (DC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:ABERG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 W COUNTRY CLUB LN STE H
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-1226
Mailing Address - Country:US
Mailing Address - Phone:760-740-9799
Mailing Address - Fax:760-740-0301
Practice Address - Street 1:555 W COUNTRY CLUB LN STE H
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-1226
Practice Address - Country:US
Practice Address - Phone:760-740-9799
Practice Address - Fax:760-740-9799
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19874111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU09191Medicare UPIN