Provider Demographics
NPI:1609106137
Name:ABRAMSON, SIMON GEDALI (MD)
Entity Type:Individual
Prefix:
First Name:SIMON
Middle Name:GEDALI
Last Name:ABRAMSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SHIMON
Other - Middle Name:GEDALI
Other - Last Name:ABRAMSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2825 OAK LAWN AVE UNIT 192749
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-4688
Mailing Address - Country:US
Mailing Address - Phone:844-389-5711
Mailing Address - Fax:877-880-2039
Practice Address - Street 1:3801 MIRANDA AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1207
Practice Address - Country:US
Practice Address - Phone:650-852-3274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1303132085R0202X, 2085R0202X
FLME1128772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology