Provider Demographics
NPI:1508027137
Name:ROBERT J. ABRAMS, DPM
Entity Type:Organization
Organization Name:ROBERT J. ABRAMS, DPM
Other - Org Name:MOORPARK FOOT AND ANKLE SPECIALIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ABRAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:805-523-0400
Mailing Address - Street 1:24355 LYONS AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2300
Mailing Address - Country:US
Mailing Address - Phone:661-253-3668
Mailing Address - Fax:661-253-2872
Practice Address - Street 1:530 NEW LOS ANGELES AVE.
Practice Address - Street 2:SUITE 210
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-2081
Practice Address - Country:US
Practice Address - Phone:805-523-0400
Practice Address - Fax:805-523-0014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3397332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT19320Medicare UPIN
CA4767590002Medicare NSC