Provider Demographics
NPI:1275027153
Name:ABDI, DAVID (LE)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ABDI
Suffix:
Gender:M
Credentials:LE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28297 CORTE OCASO
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-3081
Mailing Address - Country:US
Mailing Address - Phone:951-775-6031
Mailing Address - Fax:
Practice Address - Street 1:28481 RANCHO CALIFORNIA RD STE 209
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-3619
Practice Address - Country:US
Practice Address - Phone:951-775-6031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-9556174V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174V00000XOther Service ProvidersClinical Ethicist