Provider Demographics
NPI:1790512366
Name:ABEAR, NINO PATRICIO
Entity type:Individual
Prefix:
First Name:NINO PATRICIO
Middle Name:
Last Name:ABEAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25153 CYPRESS BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-1459
Mailing Address - Country:US
Mailing Address - Phone:818-476-2628
Mailing Address - Fax:
Practice Address - Street 1:25153 CYPRESS BLUFF DR
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91387-1459
Practice Address - Country:US
Practice Address - Phone:818-476-2628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company