Healthcare Provider Details

I. General information

NPI: 1740685387
Provider Name (Legal Business Name): MATTHEW WAYNE ABINANTE DO, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2014
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18800 DELAWARE ST STE 800
HUNTINGTON BEACH CA
92648-6019
US

IV. Provider business mailing address

2729 BRISTOL ST
COSTA MESA CA
92626-7930
US

V. Phone/Fax

Practice location:
  • Phone: 888-223-7863
  • Fax:
Mailing address:
  • Phone: 714-916-5210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number20A13506
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A13506
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: