Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 277884 | NY |
Y | 207PP0204X | Pediatric Emergency Physician | A168544 | CA |
NPI | 1588921241 |
---|---|
Provider Name | Mr. Guillermo Alberto De Angulo |
First Address | Palo Alto, CA 94304-1905 |
Second Address | Palo Alto, CA 94304-1905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2012 |
Last Update Date | 21/07/2020 |