Provider Demographics
NPI:1548202245
Name:ABRAMS, REID A (MD)
Entity Type:Individual
Prefix:DR
First Name:REID
Middle Name:A
Last Name:ABRAMS
Suffix:
Gender:M
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:PO BOX 232410
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-9000
Mailing Address - Country:US
Mailing Address - Phone:619-543-5555
Mailing Address - Fax:619-543-2540
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:MAIL CODE 8894
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9000
Practice Address - Country:US
Practice Address - Phone:619-543-5555
Practice Address - Fax:619-543-2540
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG59829207XS0106X
ARG59829207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G598290Medicaid
CAA44301Medicare UPIN
CA00G598290Medicaid