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General NPI Number Information
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NPI Number | 1104978568
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Entity Type | Individual
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Provider Name | MARYAM A. ABDELNABY MD
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 03/05/2020
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Provider Practice Location Address
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Address Line | 25825 VERMONT AVE
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City | HARBOR CITY
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State | CA
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Zip | 90710-3518
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Country | US
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Telephone | 310-325-5111
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Fax |
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Provider Business Mailing Address
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Address Line | 2563 PLAZA DEL AMO UNIT 406
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City | TORRANCE
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State | CA
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Zip | 90503-8958
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Country | US
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Telephone | 310-991-6569
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A80495
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License Number State | CA
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