| Angelita S Beredo Md Inc | |
|
301 N Prairie Ave Suite 301 Inglewood CA 90301-4507 | |
| (310) 671-2699 | |
| (310) 671-6541 |
| Full Name | Angelita S Beredo Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 301 N Prairie Ave, Inglewood, California |
| Authorized Official Name and Position | Angelita S Beredo (PRESIDENT) |
| Authorized Official Contact | 3106712699 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angelita S Beredo Md Inc 4220 Michelle Dr Torrance CA 90503-2413 Ph: (310) 671-2699 | Angelita S Beredo Md Inc 301 N Prairie Ave Suite 301 Inglewood CA 90301-4507 Ph: (310) 671-2699 |
| NPI Number | 1255471959 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6608952924 |
|---|---|
| Medicare Enrollment ID | O20080327000294 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255471959 | NPI | - | NPPES |
| 00A397440 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Angelita S Beredo |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1619158318 PECOS PAC ID: 6709962384 Enrollment ID: I20080324000178 |
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