Provider Demographics
NPI:1013736479
Name:TOBAR, ANGELA CLAUDIA (RADT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:CLAUDIA
Last Name:TOBAR
Suffix:
Gender:F
Credentials:RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2713 GREENTOP ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-3641
Mailing Address - Country:US
Mailing Address - Phone:310-689-8925
Mailing Address - Fax:
Practice Address - Street 1:6119 AGRA ST
Practice Address - Street 2:
Practice Address - City:BELL GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90201-1700
Practice Address - Country:US
Practice Address - Phone:310-689-8925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR15224008232083A0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine