Provider Demographics
NPI:1699231886
Name:ANGERS-GOULET, MATHIEU (MD MENG)
Entity type:Individual
Prefix:DR
First Name:MATHIEU
Middle Name:
Last Name:ANGERS-GOULET
Suffix:
Gender:M
Credentials:MD MENG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 47E RUE EST
Mailing Address - Street 2:
Mailing Address - City:QUEBEC
Mailing Address - State:QUEBEC
Mailing Address - Zip Code:124
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 N. STATE STREET
Practice Address - Street 2:GNH 3900
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-409-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA160738207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma