Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A137904 | CA |
Y | 208600000X | Surgeon | A137904 | CA |
N | 208200000X | Surgeon | ME125705 | FL |
N | 208600000X | Surgeon | ME125705 | FL |
NPI | 1013159912 |
---|---|
Provider Name | Dr. Carlos Manuel Angeles San Mateo |
First Address | San Rafael, CA 94903-3308 |
Second Address | San Rafael, CA 94903-3308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2009 |
Last Update Date | 17/12/2021 |