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General NPI Number Information
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NPI Number | 1255737110
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Entity Type | Organization
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Legal Business Name | ANNA P. ABALOS, M.D., INC.
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Dates
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Enumeration Date | 11/05/2014
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Last Update Date | 11/05/2014
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Provider Practice Location Address
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Address Line | 701 PLEASANT GROVE BLVD SUITE 125
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City | ROSEVILLE
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State | CA
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Zip | 95678-6156
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Country | US
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Telephone | 916-784-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 701 PLEASANT GROVE BLVD SUITE 125
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City | ROSEVILLE
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State | CA
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Zip | 95678-6156
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Country | US
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Telephone | 916-784-7700
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Fax |
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Authorized Official
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Title or Position | FAMILY PHYSICIAN
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Name | DR. ANNA P ABALOS
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Credential | M.D.
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Telephone | 916-784-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 685417
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License Number State | CA
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