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General NPI Number Information
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NPI Number | 1295858215
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Entity Type | Individual
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Provider Name | DAVID ROBLES ABIVA II PA-C
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Gender | Male
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 12522 LAMBERT RD
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City | WHITTIER
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State | CA
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Zip | 90606-2758
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Country | US
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Telephone | 562-789-5420
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Fax | 562-967-2929
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Provider Business Mailing Address
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Address Line | 16418 MYRA LN
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City | CERRITOS
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State | CA
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Zip | 90703-1524
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Country | US
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Telephone | 714-318-4843
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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 | PA17760
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA17760
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License Number State | CA
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