Ilona Abraham MD Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A25564 Issued in CA

Legal business name

ILONA ABRAHAM MD INC

Practice address

17815 Ventura Blvd
Suite 113
Encino, CA 91316-3610

Phone

(818) 345-8721

Fax

(818) 345-7150

NPI assigned

May 3, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ilona Abraham, MDNPI 1700939576

Title

President

Phone

(818) 345-8721

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ilona Abraham, MD

  • General Practice Physician
  • Encino, CA
  • NPI 1700939576
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265241600000",
    "number": "1366654568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17815 VENTURA BLVD",
            "address_2": "SUITE 113",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163610",
            "telephone_number": "818-345-8721",
            "fax_number": "818-345-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17815 VENTURA BLVD",
            "address_2": "SUITE 113",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163610",
            "telephone_number": "818-345-8721",
            "fax_number": "818-345-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILONA ABRAHAM MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2010-02-04",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "ILONA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-345-8721",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A25564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Encino, CA
• Providers in Encino, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.