Provider Demographics
NPI:1306685821
Name:ABAGAT, RAYMOND CARLOS (FNP)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:CARLOS
Last Name:ABAGAT
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19421 GALWAY AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-1921
Mailing Address - Country:US
Mailing Address - Phone:310-804-0948
Mailing Address - Fax:
Practice Address - Street 1:4320 MARICOPA ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4314
Practice Address - Country:US
Practice Address - Phone:310-804-0948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-23
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030209363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily