Provider Demographics
NPI:1770677379
Name:ABAWI INC.
Entity Type:Organization
Organization Name:ABAWI INC.
Other - Org Name:INDEPENDENT MOBILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRIDOON
Authorized Official - Middle Name:
Authorized Official - Last Name:ABAWI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-272-9884
Mailing Address - Street 1:8677 VILLA LA JOLLA DR. #1254
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92064
Mailing Address - Country:US
Mailing Address - Phone:888-272-9884
Mailing Address - Fax:888-873-0433
Practice Address - Street 1:12600 STOWE DR. #4
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064
Practice Address - Country:US
Practice Address - Phone:888-272-9884
Practice Address - Fax:888-873-0433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44602332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME03138FMedicaid
CADME03138FMedicaid