Provider Demographics
NPI:1538220835
Name:ATIGA, VIOLETA ANGELES (MD)
Entity type:Individual
Prefix:DR
First Name:VIOLETA
Middle Name:ANGELES
Last Name:ATIGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 WICK LN
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-3082
Mailing Address - Country:US
Mailing Address - Phone:213-215-5998
Mailing Address - Fax:
Practice Address - Street 1:408 W BASELINE RD
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4801
Practice Address - Country:US
Practice Address - Phone:626-914-2893
Practice Address - Fax:626-335-4767
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40731207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA40731Medicare ID - Type UnspecifiedPROVIDER
CAB50442Medicare UPIN