Provider Demographics
NPI:1215921697
Name:ANGUIANO, FRANCISCO ERNESTO (MD)
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:ERNESTO
Last Name:ANGUIANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 MEDICAL CENTER CT
Mailing Address - Street 2:SUITE 209
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-6600
Mailing Address - Country:US
Mailing Address - Phone:619-427-8892
Mailing Address - Fax:619-422-7660
Practice Address - Street 1:765 MEDICAL CENTER CT
Practice Address - Street 2:SUITE 209
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6600
Practice Address - Country:US
Practice Address - Phone:619-427-8892
Practice Address - Fax:619-422-7660
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
CAG61584174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G615840Medicaid
CAG61584Medicare ID - Type Unspecified
CA00G615840Medicaid