Healthcare Provider Details
I. General information
NPI: 1912177262
Provider Name (Legal Business Name): LAWRENCE K ABEND, DPM
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/03/2008
Last Update Date: 03/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
927 DEEP VALLEY DR STE 250
ROLLING HILLS ESTATES CA
90274-3841
US
IV. Provider business mailing address
927 DEEP VALLEY DR STE 250
ROLLING HILLS ESTATES CA
90274-3841
US
V. Phone/Fax
- Phone: 310-377-6926
- Fax:
- Phone: 310-377-6926
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LAWRENCE
KENNETH
ABEND
Title or Position: OWNER
Credential: DPM
Phone: 310-377-6926