Provider Demographics
NPI:1396962072
Name:MORGAN, ABIGAIL (LAC)
Entity type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 WESTERLY TER
Mailing Address - Street 2:#2
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-2149
Mailing Address - Country:US
Mailing Address - Phone:310-567-7001
Mailing Address - Fax:818-952-7993
Practice Address - Street 1:1808 VERDUGO BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-1477
Practice Address - Country:US
Practice Address - Phone:310-567-7001
Practice Address - Fax:818-952-7993
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11757171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist