Healthcare Provider Details

I. General information

NPI: 1477489656
Provider Name (Legal Business Name): SARAH ABRAHEM OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23000 ATLANTIC CIR
MORENO VALLEY CA
92553-5990
US

IV. Provider business mailing address

23000 ATLANTIC CIR
MORENO VALLEY CA
92553-5990
US

V. Phone/Fax

Practice location:
  • Phone: 951-924-1877
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36293
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: