Provider Demographics
NPI:1104995919
Name:ABARY, ALEXANDER V (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:V
Last Name:ABARY
Suffix:
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 1:3750 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807
Mailing Address - Country:US
Mailing Address - Phone:562-981-0732
Mailing Address - Fax:562-981-0753
Practice Address - Street 1:3750 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807
Practice Address - Country:US
Practice Address - Phone:562-981-0732
Practice Address - Fax:562-981-0753
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33405207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA33405OtherPTAN
CA00A334050Medicaid
A84471Medicare UPIN