Basic Information
Provider Information
NPI: 1578560389
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BELL
FirstName: ANGELA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2130 FILLMORE ST
Address2: #223
City: SAN FRANCISCO
State: CA
PostalCode: 941152224
CountryCode: US
TelephoneNumber: 4158282420
FaxNumber:  
Practice Location
Address1: 1 MEDICAL PLAZA DR
Address2: DEPARTMENT OF EMERGENCY MEDICINE
City: ROSEVILLE
State: CA
PostalCode: 956613037
CountryCode: US
TelephoneNumber: 9167811800
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/07/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XF40656CAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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