Provider Demographics
NPI:1992020853
Name:DINI, ANGELIA NICHOLE (IDC)
Entity Type:Individual
Prefix:
First Name:ANGELIA
Middle Name:NICHOLE
Last Name:DINI
Suffix:
Gender:F
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13106 SAINTSBURY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253
Mailing Address - Country:US
Mailing Address - Phone:760-805-9548
Mailing Address - Fax:
Practice Address - Street 1:USS MCCAMPBELL DDG 85
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96672-1275
Practice Address - Country:US
Practice Address - Phone:315-243-2257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman