Provider Demographics
NPI:1417292707
Name:ANGELS PEDIATRICS, INC.
Entity type:Organization
Organization Name:ANGELS PEDIATRICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ANGELS PEDIATRICS, INC.
Authorized Official - Prefix:DR
Authorized Official - First Name:ENAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-322-5515
Mailing Address - Street 1:1515 E ALLUVIAL AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3832
Mailing Address - Country:US
Mailing Address - Phone:559-322-5515
Mailing Address - Fax:559-322-5915
Practice Address - Street 1:1515 E ALLUVIAL AVE STE 105
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3832
Practice Address - Country:US
Practice Address - Phone:559-322-5515
Practice Address - Fax:559-322-5915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110082208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty