Provider Demographics
NPI:1215216528
Name:ABRAHAMIAN, SERJIK (MD)
Entity Type:Individual
Prefix:
First Name:SERJIK
Middle Name:
Last Name:ABRAHAMIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SERJ
Other - Middle Name:
Other - Last Name:ABRAHAMIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10800 MAGNOLIA AVENUE
Mailing Address - Street 2:KAISER PERMANENTE - FAMILY MEDICINE DEPT
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10800 MAGNOLIA AVENUE
Practice Address - Street 2:KAISER PERMANENTE - FAMILY MEDICINE DEPT
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505
Practice Address - Country:US
Practice Address - Phone:951-353-3854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA117584207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine