Anak-Agung-Gede, Angela Iskandar

Anak-Agung-Gede, Angela Iskandar is an sole proprietor health care provider with primary practice located at 480 4Th Avenue Suite 307, Chula Vista CA 91910. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Anak-Agung-Gede, Angela Iskandar can be contacted via phone (619) 426-3240.

Contact Information

Primary practice address
480 4Th Avenue Suite 307 Chula Vista CA 91910
Phone: (619) 426-3240
Fax: (619) 426-5964
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 19998 California

Profile Details

NPI number 1790912103
LBN Legal business name Anak-Agung-Gede, Angela Iskandar
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 12th, 2009
Last updated Sep 20th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790912103 NPPES
California Other 19998 STATE LICENSE

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