Provider Demographics
NPI:1912598293
Name:A. CAMPEN, MD, INC.
Entity Type:Organization
Organization Name:A. CAMPEN, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELIQUE
Authorized Official - Middle Name:SCHULDENFREI
Authorized Official - Last Name:CAMPEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-788-3409
Mailing Address - Street 1:700 N BRAND BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-3235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 N BRAND BLVD STE 220
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-3235
Practice Address - Country:US
Practice Address - Phone:818-905-1700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty