Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | A64241 | CA |
Y | 207PE0004X | Emergency Medical Services | A64241 | CA |
NPI | 1124061536 |
---|---|
Provider Name | Angelique Schuldenfrei Campen |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Burbank, CA 91505-4809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 10/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A642410 | (05) | CA |
H16635 | (02) | CA |