Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A105474 | CA |
N | 111NI0900X | Internist | A105474 | CA |
N | 207RH0002X | Hospice and Palliative Medicine | A105474 | CA |
NPI | 1124259890 |
---|---|
Provider Name | Dr. Anna-Maria Kourumalos Angelakis |
First Address | Newport Beach, CA 92659-8589 |
Second Address | Newport Beach, CA 92663-4162 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2009 |
Last Update Date | 19/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P01288980 | MEDICARE RAILROAD (01) | CA |