Provider Demographics
NPI:1740394337
Name:ABEND, RICHARD MARK (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MARK
Last Name:ABEND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:555 SOQUEL AVE
Mailing Address - Street 2:STE 350
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2336
Mailing Address - Country:US
Mailing Address - Phone:831-458-1188
Mailing Address - Fax:831-458-1189
Practice Address - Street 1:555 SOQUEL AVE
Practice Address - Street 2:STE 350
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2336
Practice Address - Country:US
Practice Address - Phone:831-458-1188
Practice Address - Fax:831-458-1189
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA15627111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0156270Medicare UPIN