Provider Demographics
NPI:1164694907
Name:ABDELNUR, DIEGO ROBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:DIEGO
Middle Name:ROBERTO
Last Name:ABDELNUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 VINE ST
Mailing Address - Street 2:APT 311S
Mailing Address - City:HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7359
Mailing Address - Country:US
Mailing Address - Phone:310-365-5805
Mailing Address - Fax:
Practice Address - Street 1:1555 VINE ST
Practice Address - Street 2:APT 311S
Practice Address - City:HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90028-7359
Practice Address - Country:US
Practice Address - Phone:310-365-5805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95710207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine