Healthcare Provider Details

I. General information

NPI: 1992763205
Provider Name (Legal Business Name): ABHIJIT A ADHYE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 TRANCAS ST STE 211
NAPA CA
94558-2909
US

IV. Provider business mailing address

1100 TRANCAS ST STE 211
NAPA CA
94558-2909
US

V. Phone/Fax

Practice location:
  • Phone: 707-637-4108
  • Fax: 707-637-4186
Mailing address:
  • Phone: 707-637-4108
  • Fax: 707-637-4186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License NumberA94870
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA94870
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: