Provider Demographics
NPI:1912986225
Name:DEL MUNDO, M.ANGELI C (MD)
Entity Type:Individual
Prefix:
First Name:M.ANGELI
Middle Name:C
Last Name:DEL MUNDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25500 N. NORTERRA PARKWAY, BLDG B
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085
Mailing Address - Country:US
Mailing Address - Phone:623-277-1000
Mailing Address - Fax:602-906-2789
Practice Address - Street 1:3530 S. VAL VISTA DRIVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297
Practice Address - Country:US
Practice Address - Phone:480-722-2340
Practice Address - Fax:480-722-2360
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24290207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ363234Medicaid
AZ64792Medicare ID - Type Unspecified
AZG34047Medicare UPIN