Individual provider Active NPI

Angelica Duenas, M.D.

  • Internal Medicine Physician
  • Marina del Rey, CA
National Provider Identifier
1619982311
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A62406 Issued in CA
Practice address
578 Washington Blvd
Suite # 825
Marina del Rey, CA 90292-5421
Phone
(310) 600-2787
Fax
(310) 306-4852
NPI assigned
Jul 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A62406 CA Primary

Addresses

Primary practice location

578 Washington Blvd
Suite # 825
Marina del Rey, CA 90292-5421

Mailing address

578 Washington Blvd
Suite # 825
Marina del Rey, CA 90292-5421
Phone (310) 600-2787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A62406CAMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619982311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 WASHINGTON BLVD",
            "address_2": "SUITE # 825",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925421",
            "telephone_number": "310-600-2787",
            "fax_number": "310-306-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 WASHINGTON BLVD",
            "address_2": "SUITE # 825",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925421",
            "telephone_number": "310-600-2787",
            "fax_number": "310-306-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUENAS",
        "first_name": "ANGELICA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A62406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.