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General NPI Number Information
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NPI Number | 1023119278
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Entity Type | Individual
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Provider Name | TOMAS ERMIAS ABRAHAM RPT
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 326 N SOTO ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-1815
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Country | US
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Telephone | 877-400-0084
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Fax | 877-400-0084
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Provider Business Mailing Address
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Address Line | 10021 TABOR ST #215
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City | LOS ANGELES
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State | CA
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Zip | 90034-4973
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Country | US
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Telephone | 877-400-0084
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Fax | 877-400-0084
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT27774
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License Number State | CA
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