Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 320 | CA |
NPI | 1003192576 |
---|---|
Provider Name | Ms. Angela F Burwick |
First Address | Claremont, CA 91711-3528 |
Second Address | Claremont, CA 91711-3528 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2011 |
Last Update Date | 28/10/2011 |