Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | A67324 | CA |
N | 207RI0200X | Infectious Disease | A67324 | CA |
N | 207RP1001X | Pulmonary Disease | A67324 | CA |
NPI | 1093743924 |
---|---|
Provider Name | Glen Abergel |
First Address | Rancho Cordova, CA 95670-7956 |
Second Address | Oxnard, CA 93030-7640 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 13/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A673240 | (05) | CA |
H67235 | (02) |