Provider Demographics
NPI:1891090163
Name:ABAIAN, MEKABIZ (MD)
Entity Type:Individual
Prefix:
First Name:MEKABIZ
Middle Name:
Last Name:ABAIAN
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 1:325 W HOSPITALITY LN STE 312
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3212
Mailing Address - Country:US
Mailing Address - Phone:909-427-5521
Mailing Address - Fax:
Practice Address - Street 1:325 W HOSPITALITY LN STE 312
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3212
Practice Address - Country:US
Practice Address - Phone:909-427-5521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1209782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry