Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 59827 | CA |
NPI | 1083089668 |
---|---|
Provider Name | Dr. Abier Abdulwahab |
First Address | Gardena, CA 90249-4430 |
Second Address | Gardena, CA 90249-4430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2015 |
Last Update Date | 08/12/2015 |