Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A135779 | CA |
Y | 111NI0900X | Internist | A135779 | CA |
N | 207RC0200X | Critical Care Medicine | A135779 | CA |
N | 207RP1001X | Pulmonary Disease | A135779 | CA |
N | 207RS0012X | Sleep Medicine | A135779 | CA |
NPI | 1013277102 |
---|---|
Provider Name | Dr. Abigail Maller |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Burbank, CA 91505-4822 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2012 |
Last Update Date | 15/12/2021 |