Provider Demographics
NPI:1043771728
Name:FLEISNER, ABIGAIL (LAC, DACM)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:
Last Name:FLEISNER
Suffix:
Gender:F
Credentials:LAC, DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4565 PESCADERO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-3536
Mailing Address - Country:US
Mailing Address - Phone:858-882-7689
Mailing Address - Fax:
Practice Address - Street 1:3646 MIDWAY DR # B
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-5201
Practice Address - Country:US
Practice Address - Phone:619-223-1617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18244171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist