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General NPI Number Information
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NPI Number | 1164983748
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Entity Type | Individual
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Provider Name | ABDULRAHMAN HASSAN ABONOFAL MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2019
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 1710 N 159TH AVE
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City | GOODYEAR
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State | AZ
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Zip | 85395-7687
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Country | US
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Telephone | 623-312-3020
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 60691
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91716-0691
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Country | US
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Telephone | 480-821-2838
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 31499
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number | 76282
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License Number State | AZ
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