Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | G830270 | CA |
N | 2084N0402X | Child Neurologist | G83027 | CA |
N | 2084N0600X | Clinical Neurophysiologist | 00G83027 | CA |
NPI | 1174542047 |
---|---|
Provider Name | Dr. Angela Anagnos |
First Address | San Jose, CA 95128-5130 |
Second Address | San Jose, CA 95128-5130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 21/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G830270 | BLUE SHIELD (01) | CA |
00G830271 | BLUE SHIELD (01) | CA |
H53926 | (02) | CA |