Provider Demographics
NPI:1013044734
Name:LOEBENSTEIN, ABRAHAM MEYER (PHD)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:MEYER
Last Name:LOEBENSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1422 TAMARISK WEST ST
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-2537
Mailing Address - Country:US
Mailing Address - Phone:858-997-5855
Mailing Address - Fax:
Practice Address - Street 1:5755 OBERLIN DR STE 317
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1786
Practice Address - Country:US
Practice Address - Phone:858-997-5855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15631103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY15631AMedicaid
CAPSY15631AMedicaid
CACP15631AMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CAWCP15631BMedicare ID - Type UnspecifiedPPIN