Provider Demographics
NPI:1376726174
Name:ABRAHAMS, ARIEL E (MD)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:E
Last Name:ABRAHAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SHAHRAM
Other - Middle Name:ELIAHOU
Other - Last Name:TEHRANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 252125
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-8977
Mailing Address - Country:US
Mailing Address - Phone:562-634-4659
Mailing Address - Fax:562-634-8217
Practice Address - Street 1:11525 BROOKSHIRE AVE.
Practice Address - Street 2:STE 301
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4982
Practice Address - Country:US
Practice Address - Phone:562-923-1112
Practice Address - Fax:562-923-1118
Is Sole Proprietor?:No
Enumeration Date:2007-12-14
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG86496207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G864940Medicaid
481301689OtherTAX ID
CA00G864940Medicaid
CAW19585Medicare PIN