Provider Demographics
NPI:1245289339
Name:ABRAMOWITZ, BRYAN LAWRENCE (MD)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:LAWRENCE
Last Name:ABRAMOWITZ
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 1:4282 GENESEE AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-4985
Mailing Address - Country:US
Mailing Address - Phone:858-836-2491
Mailing Address - Fax:858-836-2496
Practice Address - Street 1:4282 GENESEE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-4946
Practice Address - Country:US
Practice Address - Phone:858-430-1651
Practice Address - Fax:858-292-0719
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63977207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA63977Medicare ID - Type Unspecified
CAH47350Medicare UPIN