Provider Demographics
NPI:1831350784
Name:SEQUEIRA ABARCA, ERNESTO LEONEL SR (MD)
Entity type:Individual
Prefix:MR
First Name:ERNESTO
Middle Name:LEONEL
Last Name:SEQUEIRA ABARCA
Suffix:SR
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 1:17207 JASMINE ST STE 2
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-8322
Mailing Address - Country:US
Mailing Address - Phone:442-284-0080
Mailing Address - Fax:
Practice Address - Street 1:17207 JASMINE ST STE 2
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-8322
Practice Address - Country:US
Practice Address - Phone:442-284-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA114585207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine