Individual
DR. AGUSTIN MARIA ABDALLAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
245 S FETTERLY AVE, LOS ANGELES, CA 90022-1605
(323) 362-1010
Mailing address
1200 N STATE ST, CT-A7D, LOS ANGELES, CA 90033-1029
(323) 226-7556
(323) 226-2657
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
141310
CA
208000000X
Pediatrics Physician
141310
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA3232267556
AA3232267556
—
Enumeration date
11/01/2014
Last updated
11/23/2020
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