Provider Demographics
NPI:1942240403
Name:ABDOLLAHI, KARIM (MD)
Entity Type:Individual
Prefix:
First Name:KARIM
Middle Name:
Last Name:ABDOLLAHI
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:PO BOX 6974
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92607-6974
Mailing Address - Country:US
Mailing Address - Phone:949-499-8226
Mailing Address - Fax:949-499-2430
Practice Address - Street 1:31862 COAST HWY
Practice Address - Street 2:SUITE 400
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-6769
Practice Address - Country:US
Practice Address - Phone:949-499-8226
Practice Address - Fax:949-499-2430
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG73446207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G734460Medicaid
CA00G734460Medicaid
CAG73446Medicare ID - Type UnspecifiedPROVIDER #