Provider Demographics
NPI:1093019911
Name:ABELSON, RICK (OD)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:
Last Name:ABELSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 AVENIDA PICO STE H
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-5695
Mailing Address - Country:US
Mailing Address - Phone:949-545-0257
Mailing Address - Fax:949-498-8238
Practice Address - Street 1:806 AVENIDA PICO STE H
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-5695
Practice Address - Country:US
Practice Address - Phone:949-545-0257
Practice Address - Fax:949-498-8238
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9174 T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist