# DR. ABID CHRISTOPHER MOGANNAM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1598056483
- **Gender:** Man
- **Credential:** M.D., M.B.A.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | A123990 | CA | — |
| 2086S0129X | Vascular Surgery Physician | A123990 | CA | — |
| 2086S0129X | Vascular Surgery Physician | LT15520 | ND | Yes |

## Other

- **Enumeration date:** 04/26/2011
- **Last updated:** 01/23/2019