Healthcare Provider Details

I. General information

NPI: 1629088448
Provider Name (Legal Business Name): LAWRENCE KENNETH ABEND DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 02/24/2022
Certification Date: 02/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 DEEP VALLEY DR STE 204
ROLLING HILLS ESTATES CA
90274-3654
US

IV. Provider business mailing address

827 DEEP VALLEY DR STE 204
ROLLING HILLS ESTATES CA
90274-3654
US

V. Phone/Fax

Practice location:
  • Phone: 310-377-6926
  • Fax: 310-541-5746
Mailing address:
  • Phone: 310-377-6926
  • Fax: 310-541-5746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE3015
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: