Individual
DR. REGINALD G M ABRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M D
Contact information
Practice address
11100 WARNER AVE, SUITE 258, FOUNTAIN VALLEY, CA 92708-7506
(714) 549-5990
(714) 549-0866
Mailing address
11100 WARNER AVE, SUITE 258, FOUNTAIN VALLEY, CA 92708-7506
(714) 549-5990
(714) 845-0041
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A75917
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
A75917
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A75917
—
CA
Enumeration date
04/14/2006
Last updated
06/05/2012
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