Healthcare Provider Details

I. General information

NPI: 1649469628
Provider Name (Legal Business Name): MICHAEL H ABDULIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 11/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W EULALIA ST SUITE 300
GLENDALE CA
91204-2849
US

IV. Provider business mailing address

PO BOX 27206
LOS ANGELES CA
90027-0206
US

V. Phone/Fax

Practice location:
  • Phone: 818-547-0608
  • Fax:
Mailing address:
  • Phone: 213-385-0675
  • Fax: 213-365-6429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA118845
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number57013123
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: