Provider Demographics
NPI:1205208899
Name:MICHAEL ABDULIAN MD INC
Entity Type:Organization
Organization Name:MICHAEL ABDULIAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDULIAA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-401-1934
Mailing Address - Street 1:3940 LAUREL CANYON BLVD
Mailing Address - Street 2:#1568
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-3709
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3940 LAUREL CANYON BLVD
Practice Address - Street 2:#1568
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-3709
Practice Address - Country:US
Practice Address - Phone:323-401-1934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA118845207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty