Healthcare Provider Details

I. General information

NPI: 1154103463
Provider Name (Legal Business Name): MR. MICHAEL ABUNDA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2023
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 TAMALPAIS DR STE 410
CORTE MADERA CA
94925-1739
US

IV. Provider business mailing address

1911 31ST AVE
SAN FRANCISCO CA
94116-1118
US

V. Phone/Fax

Practice location:
  • Phone: 415-925-1822
  • Fax: 415-463-1145
Mailing address:
  • Phone: 415-271-8614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number8866
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: