MEDICARE: MARC R. ABRAMS, M.D., INC.

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	207Q00000X	Family Medicine Physician	36795	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952569451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARC R. ABRAMS, M.D., INC.

Provider Business Mailing Address
First Line	:	12626 RIVERSIDE DR
Second Line	:	SUITE 409
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91607-3420
Country	:	US
Telephone Number	:	818-752-9792
Fax Number	:	818-752-9797

Provider Business Practice Location Address
First Line	:	12626 RIVERSIDE DR
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91607-3420
Country	:	US
Telephone Number	:	818-752-9792
Fax Number	:	818-752-9797

Authorized Official
Title or Position	:	PHYSICIAN / OWNER
Name	:	MARC R ABRAMS
Credential	:	M.D.
Telephone Number	:	818-752-9792

Provider Enumeration Date	:	05/30/2008
Last Update Date	:	05/30/2008

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