Provider Demographics
NPI:1841084795
Name:ANGELIQUE CAMPEN MD INC
Entity type:Organization
Organization Name:ANGELIQUE CAMPEN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-788-3409
Mailing Address - Street 1:7 SANDPIPER STRAND
Mailing Address - Street 2:
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118-3211
Mailing Address - Country:US
Mailing Address - Phone:323-788-3409
Mailing Address - Fax:
Practice Address - Street 1:5325 ANITA ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-5333
Practice Address - Country:US
Practice Address - Phone:323-788-3409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty