Provider Demographics
NPI:1407485329
Name:THENAPPAN, ABINAYA (MD)
Entity type:Individual
Prefix:
First Name:ABINAYA
Middle Name:
Last Name:THENAPPAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3385 MICHELSON DR APT 163
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-3458
Mailing Address - Country:US
Mailing Address - Phone:562-219-1030
Mailing Address - Fax:
Practice Address - Street 1:1501 SUPERIOR AVE STE 315
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3641
Practice Address - Country:US
Practice Address - Phone:562-219-1030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-02
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.150037207W00000X
CAA184685207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology