MEDICARE: JASON ABDIAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	A196042	CA

General Provider Information

NPI Number	:	1558935577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON ABDIAN MD

Provider Business Mailing Address
First Line	:	1107 S ALVARADO ST STE 102
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-4161
Country	:	US
Telephone Number	:	213-380-9999
Fax Number	:	213-380-7904

Provider Business Practice Location Address
First Line	:	1107 S ALVARADO ST STE 102
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-4161
Country	:	US
Telephone Number	:	213-380-9999
Fax Number	:	213-380-7904

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2021
Last Update Date	:	08/12/2025

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