MEDICARE: PETER ABACI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	G76565	CA
2	208VP0014X	Interventional Pain Medicine Physician	G76565	CA
3	208VP0000X	Pain Medicine Physician	G76565	CA
4	207LP2900X	Pain Medicine (Anesthesiology) Physician	G76565	CA

General Provider Information

NPI Number	:	1447200761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER ABACI MD

Provider Business Mailing Address
First Line	:	15047 LOS GATOS BLVD STE 200
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95032-2054
Country	:	US
Telephone Number	:	408-364-6799
Fax Number	:	408-378-4510

Provider Business Practice Location Address
First Line	:	15047 LOS GATOS BLVD STE 200
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95032-2054
Country	:	US
Telephone Number	:	408-364-6799
Fax Number	:	408-378-4510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	04/11/2017

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Directions to “ PETER ABACI MD” Practice Location

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