Provider Demographics
NPI:1376557793
Name:ABADEE, PAYANDEH (MD)
Entity Type:Individual
Prefix:DR
First Name:PAYANDEH
Middle Name:
Last Name:ABADEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11278 LOS ALAMITOS BLVD
Mailing Address - Street 2:#200
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3958
Mailing Address - Country:US
Mailing Address - Phone:310-514-5370
Mailing Address - Fax:310-514-5374
Practice Address - Street 1:1300 W 7TH ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90732-3505
Practice Address - Country:US
Practice Address - Phone:310-514-5370
Practice Address - Fax:310-514-5370
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC39494208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE47828Medicare UPIN