Provider Demographics
NPI:1447754379
Name:ABT, BRITTANY GABRIELLA (MD)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:GABRIELLA
Last Name:ABT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 S SAN PEDRO ST APT 252
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3573
Mailing Address - Country:US
Mailing Address - Phone:949-289-0107
Mailing Address - Fax:
Practice Address - Street 1:1200 N STATE STREET
Practice Address - Street 2:CLINIC TOWER STE A7D
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:949-289-0107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-23
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program