Provider Demographics
NPI:1326349960
Name:ABOVIAN, DAVID (PA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:ABOVIAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1556 THOMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-1230
Mailing Address - Country:US
Mailing Address - Phone:818-265-1699
Mailing Address - Fax:
Practice Address - Street 1:1365 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-5047
Practice Address - Country:US
Practice Address - Phone:626-857-2580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-13
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20512363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant