Provider Demographics
NPI:1235360348
Name:ABRAHAMS, ROBERT WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WILLIAM
Last Name:ABRAHAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6281 BEACH BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-4221
Mailing Address - Country:US
Mailing Address - Phone:949-444-2789
Mailing Address - Fax:
Practice Address - Street 1:6281 BEACH BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-4221
Practice Address - Country:US
Practice Address - Phone:949-444-2789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28926111N00000X
CARHC 00163187111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0200XChiropractic ProvidersChiropractorRadiology