Provider Demographics
NPI:1326304007
Name:ABHAT, ANSHU RIA
Entity type:Individual
Prefix:
First Name:ANSHU
Middle Name:RIA
Last Name:ABHAT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 HUNTINGTON LN # A
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-4311
Mailing Address - Country:US
Mailing Address - Phone:626-353-9885
Mailing Address - Fax:
Practice Address - Street 1:1000 W CARSON ST # 459
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2004
Practice Address - Country:US
Practice Address - Phone:424-306-6500
Practice Address - Fax:424-306-6500
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-06
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60289578207R00000X
CAA136998207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine