Provider Demographics
NPI:1639203656
Name:ABBOUD, WILLIAM HABIB (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HABIB
Last Name:ABBOUD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6845 INDIANA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-4206
Mailing Address - Country:US
Mailing Address - Phone:951-276-2200
Mailing Address - Fax:951-276-2400
Practice Address - Street 1:6845 INDIANA AVE STE 100
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4206
Practice Address - Country:US
Practice Address - Phone:951-276-2200
Practice Address - Fax:951-276-2400
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20895111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor