Healthcare Provider Details

I. General information

NPI: 1073469219
Provider Name (Legal Business Name): RAHGI ABAZA L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CHRISTIAN ABAZA L.AC.

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12330 STANWOOD DR
LOS ANGELES CA
90066-1057
US

IV. Provider business mailing address

12330 STANWOOD DR
LOS ANGELES CA
90066-1057
US

V. Phone/Fax

Practice location:
  • Phone: 631-741-0030
  • Fax: 631-741-0030
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number20579
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: