Healthcare Provider Details

I. General information

NPI: 1982627675
Provider Name (Legal Business Name): JOHN ESTAMO ABORDO DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 10/21/2021
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

857 W CHILDS AVE
MERCED CA
95341-6862
US

IV. Provider business mailing address

737 W CHILDS AVE
MERCED CA
95341-6805
US

V. Phone/Fax

Practice location:
  • Phone: 866-682-4842
  • Fax: 209-383-6198
Mailing address:
  • Phone: 209-383-1848
  • Fax: 209-383-1296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4625
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: