Provider Demographics
NPI:1427735265
Name:ELDERS ANGEL LLC
Entity type:Organization
Organization Name:ELDERS ANGEL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MADALINA IOANA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSOIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-868-1577
Mailing Address - Street 1:8525 GIBBS DR STE 304
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1700
Mailing Address - Country:US
Mailing Address - Phone:858-868-1577
Mailing Address - Fax:
Practice Address - Street 1:8525 GIBBS DR STE 304
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1700
Practice Address - Country:US
Practice Address - Phone:858-868-1577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care