Basic Information
| Provider Information | |||||||||
| NPI: | 1083047260 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ASHEH | ||||||||
| FirstName: | ANGELO | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5333 MISSION CENTER RD | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921081302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192953355 | ||||||||
| FaxNumber: | 6195421317 | ||||||||
| Practice Location | |||||||||
| Address1: | 5333 MISSION CENTER RD | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192953355 | ||||||||
| FaxNumber: | 6195421317 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2013 | ||||||||
| LastUpdateDate: | 04/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 17366 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 2084A0401X | 17366 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Medicine |
No ID Information.