Provider Demographics
NPI:1881690865
Name:ABRAMS, DAVID ERNEST (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ERNEST
Last Name:ABRAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18370 BURBANK BLVD
Mailing Address - Street 2:STE 414
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2804
Mailing Address - Country:US
Mailing Address - Phone:818-385-1018
Mailing Address - Fax:818-385-0896
Practice Address - Street 1:18370 BURBANK BLVD
Practice Address - Street 2:STE 414
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2804
Practice Address - Country:US
Practice Address - Phone:818-385-1018
Practice Address - Fax:818-385-0896
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG17392207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG17392AMedicare ID - Type Unspecified
CAA40071Medicare UPIN