Provider Demographics
NPI:1629088448
Name:ABEND, LAWRENCE KENNETH (DPM)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:KENNETH
Last Name:ABEND
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 DEEP VALLEY DR STE 204
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3654
Mailing Address - Country:US
Mailing Address - Phone:310-377-6926
Mailing Address - Fax:310-541-5746
Practice Address - Street 1:827 DEEP VALLEY DR STE 204
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3654
Practice Address - Country:US
Practice Address - Phone:310-377-6926
Practice Address - Fax:310-541-5746
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3015213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T11554Medicare UPIN
E3015Medicare ID - Type Unspecified