ANGELES CLINIC AND RESEARCH INSTITUTE INC

Provider Demographics

• NPI: 1841456019
• Name: ANGELES CLINIC AND RESEARCH INSTITUTE INC
• Entity type: Organization
• Organization Name: ANGELES CLINIC AND RESEARCH INSTITUTE INC
• Authorized Official - Title/Position: ASSOC. DIRECTOR OF PHARMACY SERVICE
• Authorized Official - Prefix: DR
• Authorized Official - First Name: NANAZ
• Authorized Official - Last Name: AMINI
• Authorized Official - Credentials: PHARMD
• Authorized Official - Phone: 310-231-2180
• Mailing Address - Street 1: 11800 WILSHIRE BLVD
• Mailing Address - City: LOS ANGELES
• Mailing Address - State: CA
• Mailing Address - Zip Code: 90025-6602
• Mailing Address - Country: US
• Mailing Address - Phone: 310-231-2121
• Mailing Address - Fax: 310-231-2199
• Practice Address - Street 1: 11818 WILSHIRE BLVD
• Practice Address - Street 2: SUITE 200
• Practice Address - City: LOS ANGELES
• Practice Address - State: CA
• Practice Address - Zip Code: 90025-6646
• Practice Address - Country: US
• Practice Address - Phone: 310-231-2121
• Practice Address - Fax: 310-231-2199
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2008-08-06
• Last Update Date: 2024-10-30

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207RH0003X	Allopathic & Osteopathic Physicians	Internal Medicine	Hematology & Oncology	Group - Multi-Specialty
No	207UN0902X	Allopathic & Osteopathic Physicians	Nuclear Medicine	Nuclear Imaging & Therapy	Group - Multi-Specialty
No	2085R0204X	Allopathic & Osteopathic Physicians	Radiology	Vascular & Interventional Radiology	Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
CA	W15185A	Other	MEDICARE PTAN FOR GROUP
CA	I57646	Medicare UPIN
CA	WG52155J	Medicare PIN
CA	WG20643E	Medicare PIN
CA	F04057	Medicare UPIN
CA	WG69870S	Medicare PIN
CA	A46556	Medicare UPIN
	WA74223C	Medicare PIN
CA	WA82669B	Medicare PIN
CA	A89817	Medicare UPIN
CA	A40998	Medicare UPIN
CA	WG36051L	Medicare PIN
CA	WG45466D	Medicare PIN
CA	W15185A	Other	MEDICARE PTAN FOR GROUP
CA	I33167	Medicare UPIN
	W20A6503C	Medicare PIN
CA	WA53519C	Medicare PIN
CA	A52182	Medicare UPIN
CA	B45772	Medicare UPIN
CA	E87688	Medicare UPIN
CA	WG71599U	Medicare PIN