Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | A134052 | CA |
NPI | 1306281506 |
---|---|
Provider Name | Sharlee Marie Deangelo |
First Address | Los Altos, CA 94022-1408 |
Second Address | Palo Alto, CA 94301-2302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2013 |
Last Update Date | 29/05/2020 |