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General NPI Number Information
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NPI Number | 1932620812
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Entity Type | Organization
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Legal Business Name | IMAN ABDEL BAR MD INC
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Dates
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Enumeration Date | 06/30/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2077 HARBOR BLVD UNIT A
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City | COSTA MESA
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State | CA
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Zip | 92627-2630
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Country | US
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Telephone | 949-675-6759
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Fax |
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Provider Business Mailing Address
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Address Line | 2077 HARBOR BLVD UNIT A
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City | COSTA MESA
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State | CA
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Zip | 92627-2630
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Country | US
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Telephone | 949-675-6759
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Fax |
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Authorized Official
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Title or Position | MD
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Name | DR. IMAN ABDEL BAR
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Credential | A72354
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Telephone | 949-675-6759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A72354
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License Number State | CA
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