Provider Demographics
NPI:1396905626
Name:PESIGAN, ANGELINA MARTINEZ (MD)
Entity type:Individual
Prefix:DR
First Name:ANGELINA
Middle Name:MARTINEZ
Last Name:PESIGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:ANGELINA
Other - Middle Name:PESIGAN
Other - Last Name:MAKABALI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:21304 E ARROW HWY
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-1442
Mailing Address - Country:US
Mailing Address - Phone:626-915-2055
Mailing Address - Fax:626-915-2098
Practice Address - Street 1:21304 E ARROW HWY
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-1442
Practice Address - Country:US
Practice Address - Phone:626-915-2055
Practice Address - Fax:626-915-2098
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34148363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical