Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MT198953 | PA |
N | 111NI0900X | Internist | MT198953 | PA |
Y | 208D00000X | General Practice Physician | A131722 | CA |
NPI | 1033405584 |
---|---|
Provider Name | Dr. David W Angert |
First Address | Long Beach, CA 90803-1620 |
Second Address | Long Beach, CA 90803-1620 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2011 |
Last Update Date | 04/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
19113GAP | (05) | CA |