Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY15631 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY15631 | CA |
NPI | 1013044734 |
---|---|
Provider Name | Dr. Abraham Meyer Loebenstein |
First Address | La Jolla, CA 92039-2504 |
Second Address | San Diego, CA 92130-2053 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 31/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PSY15631A | (05) | CA |