King-Angell, Joan Lucile

King-Angell, Joan Lucile is an sole proprietor health care provider with primary practice located at 3260 Sacramento St Over 60 Clinic, Berkeley CA 94702. She recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as her primary health care specialty. King-Angell, Joan Lucile can be contacted via phone (510) 274-8996.

Contact Information

Primary practice address
3260 Sacramento St Over 60 Clinic Berkeley CA 94702
Phone: (510) 274-8996
Fax: (510) 981-4191
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X G58410 California

Profile Details

NPI number 1578641346
LBN Legal business name King-Angell, Joan Lucile
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 1st, 2006
Last updated Sep 12th, 2014 - about 12 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 1578641346 NPPES
California MEDICAID 00G584100

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