Provider Demographics
NPI:1295892081
Name:ANGELES, ABDIEL M (MD)
Entity type:Individual
Prefix:DR
First Name:ABDIEL
Middle Name:M
Last Name:ANGELES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 KAMEHAMEHA AVENUE
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2256
Mailing Address - Country:US
Mailing Address - Phone:808-871-7728
Mailing Address - Fax:808-871-7729
Practice Address - Street 1:43 KAMEHAMEHA AVENUE
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2256
Practice Address - Country:US
Practice Address - Phone:808-871-7728
Practice Address - Fax:808-871-7729
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD2940207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIC98365OtherUPIN
HI00A0040137OtherHMSA
HI03644201Medicaid
HI03644201Medicaid