Provider Demographics
NPI:1003112913
Name:ABBOUD, THERESE K (MD)
Entity Type:Individual
Prefix:DR
First Name:THERESE
Middle Name:K
Last Name:ABBOUD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1820 AVENIDA DEL MUNDO
Mailing Address - Street 2:#1103
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118
Mailing Address - Country:US
Mailing Address - Phone:619-435-6556
Mailing Address - Fax:619-435-6581
Practice Address - Street 1:1820 AVENIDA DEL MUNDO
Practice Address - Street 2:#1103
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118
Practice Address - Country:US
Practice Address - Phone:619-435-6556
Practice Address - Fax:619-435-6581
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAAFE25015207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology