Healthcare Provider Details

I. General information

NPI: 1962697979
Provider Name (Legal Business Name): ALAN A ABRAMS M.D., J.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 JACKSON DR
SAN DIEGO CA
92119-3333
US

IV. Provider business mailing address

6601 JACKSON DR
SAN DIEGO CA
92119-3333
US

V. Phone/Fax

Practice location:
  • Phone: 619-666-5570
  • Fax: 619-460-0344
Mailing address:
  • Phone: 619-666-5570
  • Fax: 619-460-0344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG30135
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: