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ANGELA KWAFOA MIMI AMOANI PHYSICIAN ASSISTANT

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1881883064

Individual Registrant:
 ANGELA KWAFOA MIMI AMOANI PHYSICIAN ASSISTANT
Gender: F
Not Sole Proprietor

Location and contact information for practice:
17095 MAIN ST  HESPERIA, CA 92345-6004 US
Tel: 760-241-6666  Fax: 760-241-7575

Contact information for business:
17095 MAIN ST  HESPERIA, CA 92345-6004 US
Tel: 760-241-6666  Fax: 760-241-7575

Registration Information:
NPI: 1881883064
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
CAPAC1076081

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
PAC1076081CA05




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