MEDICARE: DYLAN SIMON ROSALES ABABOU

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
1	174H00000X	Health Educator		CA

General Provider Information

NPI Number	:	1326900440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DYLAN SIMON ROSALES ABABOU

Provider Business Mailing Address
First Line	:	711 N COURT ST
Second Line	:
City	:	VISALIA
State	:	CA
Zip	:	93291-3638
Country	:	US
Telephone Number	:	559-627-1490
Fax Number	:

Provider Business Practice Location Address
First Line	:	1799 BRIGHTSIDE ST
Second Line	:
City	:	TULARE
State	:	CA
Zip	:	93274-7480
Country	:	US
Telephone Number	:	559-699-0050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2025
Last Update Date	:	12/02/2025

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