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General NPI Number Information
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NPI Number | 1578491049
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Entity Type | Individual
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Provider Name | MARYAM ABEDRABBO OD
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Gender | Female
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 2100 ARDEN WAY STE 103
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City | SACRAMENTO
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State | CA
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Zip | 95825-2236
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Country | US
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Telephone | 973-870-1101
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Fax |
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Provider Business Mailing Address
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Address Line | 4519 OCEAN LN
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City | ELK GROVE
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State | CA
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Zip | 95757-2557
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Country | US
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Telephone | 973-870-1101
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 36211
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License Number State | CA
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