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NPI Code Detail

MEDICARE: MR. KAREEM ABDUL-JABBAR

MEDICARE:  MR. KAREEM  ABDUL-JABBAR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker83587CA

General Provider Information

NPI Number : 1235330812
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KAREEM ABDUL-JABBAR
Provider Business Mailing Address
First Line : 711 W FLORENCE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90044-6105
Country : US
Telephone Number : 323-789-5610
Fax Number : 323-789-5616
Provider Business Practice Location Address
First Line : 711 W FLORENCE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90044-6105
Country : US
Telephone Number : 323-789-5610
Fax Number : 323-789-5616
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2007
Last Update Date : 12/11/2024

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Directions to “ MR. KAREEM ABDUL-JABBAR ” Practice Location

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