Provider Demographics
NPI:1639306392
Name:NISIM, ABRAHAM AVI (MD)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:AVI
Last Name:NISIM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:500 OLD RIVER RD STE 185
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9505
Mailing Address - Country:US
Mailing Address - Phone:661-748-1886
Mailing Address - Fax:661-479-5063
Practice Address - Street 1:500 OLD RIVER RD STE 185
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9505
Practice Address - Country:US
Practice Address - Phone:661-748-1886
Practice Address - Fax:661-479-5063
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2021-08-10
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Provider Licenses
StateLicense IDTaxonomies
CAA964333208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery