Provider Demographics
NPI:1225264377
Name:ALEXANDER V. ABARY MD, INC
Entity Type:Organization
Organization Name:ALEXANDER V. ABARY MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:V
Authorized Official - Last Name:ABARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-981-0732
Mailing Address - Street 1:3750 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807
Mailing Address - Country:US
Mailing Address - Phone:562-981-0732
Mailing Address - Fax:562-981-0753
Practice Address - Street 1:3750 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807
Practice Address - Country:US
Practice Address - Phone:562-981-0732
Practice Address - Fax:562-981-0753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33405207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A334050Medicaid
CAA33405Medicare PIN
CA00A334050Medicaid