Provider Demographics
NPI:1578742896
Name:ABRAMED CORP
Entity Type:Organization
Organization Name:ABRAMED CORP
Other - Org Name:SONAFE CBAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:YEGORYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-464-5129
Mailing Address - Street 1:3200 SANTA MONICA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2638
Mailing Address - Country:US
Mailing Address - Phone:310-255-0999
Mailing Address - Fax:310-255-0941
Practice Address - Street 1:8134 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:SUNLAND
Practice Address - State:CA
Practice Address - Zip Code:91040-2941
Practice Address - Country:US
Practice Address - Phone:818-875-8366
Practice Address - Fax:818-296-9521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA060000904261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care