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General NPI Number Information
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NPI Number | 1265096531
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Entity Type | Individual
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Provider Name | MARC A ABBOUD MD
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Gender | Male
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Dates
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Enumeration Date | 04/23/2019
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 3771 KATELLA AVE STE 210
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3118
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Country | US
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Telephone | 562-430-0581
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Fax | 562-598-2110
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Provider Business Mailing Address
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Address Line | 3771 KATELLA AVE STE 210
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3118
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Country | US
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Telephone | 562-430-0581
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Fax | 562-598-2110
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | A193238
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License Number State | CA
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