Provider Demographics
NPI:1205665064
Name:ABNUSI, LEONED
Entity type:Individual
Prefix:
First Name:LEONED
Middle Name:
Last Name:ABNUSI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 SOUTH ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2208
Mailing Address - Country:US
Mailing Address - Phone:818-245-6277
Mailing Address - Fax:818-245-6278
Practice Address - Street 1:516 SOUTH ST UNIT A
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2208
Practice Address - Country:US
Practice Address - Phone:818-245-6277
Practice Address - Fax:818-245-6278
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)