Healthcare Provider Details

I. General information

NPI: 1306844626
Provider Name (Legal Business Name): ALLAN STANLEY ABRAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALLAN STANLEY ABRAMS M.D.

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1687 ERRINGER RD SUITE 106
SIMI VALLEY CA
93065-6508
US

IV. Provider business mailing address

1687 ERRINGER RD SUITE 106
SIMI VALLEY CA
93065-6508
US

V. Phone/Fax

Practice location:
  • Phone: 805-520-0462
  • Fax: 805-520-3486
Mailing address:
  • Phone: 805-520-0462
  • Fax: 805-520-3486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA21988
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: