Provider Demographics
NPI:1285736405
Name:TABURNAL, ABEGAIL (RPT)
Entity type:Individual
Prefix:MISS
First Name:ABEGAIL
Middle Name:
Last Name:TABURNAL
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4240 W 1ST ST
Mailing Address - Street 2:#305
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-4056
Mailing Address - Country:US
Mailing Address - Phone:310-940-4385
Mailing Address - Fax:
Practice Address - Street 1:1929 N FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-2205
Practice Address - Country:US
Practice Address - Phone:310-940-4385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32528225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist