Healthcare Provider Details

I. General information

NPI: 1245441104
Provider Name (Legal Business Name): ALFREDO R ABARIEN TOS MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8220 SOUTH SAN PEDRO STREET
LOS ANGELES CA
90003
US

IV. Provider business mailing address

22923 DOBLE AVE
TORRANCE CA
90502-2922
US

V. Phone/Fax

Practice location:
  • Phone: 323-789-5640
  • Fax: 323-789-5648
Mailing address:
  • Phone: 310-257-1943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: