Abraham, Reginald G M

Abraham, Reginald G M is an sole proprietor health care provider with primary practice located at 11100 Warner Ave Suite 258, Fountain Valley CA 92708-7506. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery). Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Abraham, Reginald G M can be contacted via phone (714) 549-5990.

Contact Information

Primary practice address
11100 Warner Ave Suite 258 Fountain Valley CA 92708-7506
Phone: (714) 549-5990
Fax: (714) 549-0866
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X A75917 California
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X A75917 California

Profile Details

NPI number 1720042864
LBN Legal business name Abraham, Reginald G M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 14th, 2006
Last updated Jun 5th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720042864 NPPES
California MEDICAID 00A75917

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