Provider Demographics
NPI:1972176162
Name:ANGUIANO, MIGUEL ANGEL (OPERATION SUPERVISOR)
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:ANGEL
Last Name:ANGUIANO
Suffix:
Gender:M
Credentials:OPERATION SUPERVISOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 E PALMDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-4598
Mailing Address - Country:US
Mailing Address - Phone:818-654-3887
Mailing Address - Fax:818-975-5061
Practice Address - Street 1:320 E PALMDALE BLVD
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-4598
Practice Address - Country:US
Practice Address - Phone:818-654-3887
Practice Address - Fax:818-975-5061
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty