Provider Demographics
NPI:1356481733
Name:ABUAV, RACHEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:ABUAV
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:NUSSBAUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9100 WILSHIRE BLVD STE 201W
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3415
Mailing Address - Country:US
Mailing Address - Phone:310-620-2432
Mailing Address - Fax:310-432-2432
Practice Address - Street 1:9100 WILSHIRE BLVD STE 201W
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3415
Practice Address - Country:US
Practice Address - Phone:310-620-2432
Practice Address - Fax:310-432-2432
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99028207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD014699400Medicaid
MDH766 Q880Medicare PIN
NC145684Medicare UPIN
NC2046707Medicare ID - Type Unspecified