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General NPI Number Information
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NPI Number | 1306123369
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Entity Type | Individual
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Provider Name | BRIGIDA MOMAND ABDELNABY DDS
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Gender | Female
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Dates
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Enumeration Date | 11/04/2011
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Last Update Date | 10/29/2019
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Provider Practice Location Address
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Address Line | 1441 W 8TH ST
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City | SAN PEDRO
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State | CA
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Zip | 90732-3803
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Country | US
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Telephone | 310-832-5295
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Fax |
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Provider Business Mailing Address
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Address Line | 26764 SHADOW WOOD DR
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-2351
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Country | US
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Telephone | 310-791-3327
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 36179
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License Number State | CA
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