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General NPI Number Information
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NPI Number | 1326231630
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Entity Type | Organization
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Legal Business Name | ABRHAM TEKOLA M.D. INC
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 08/20/2007
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Provider Practice Location Address
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Address Line | 5740 WINDMILL WAY SUITE # 5
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City | CARMICHAEL
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State | CA
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Zip | 95608-1379
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Country | US
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Telephone | 916-480-0506
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Fax | 916-480-0609
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Provider Business Mailing Address
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Address Line | 5740 WINDMILL WAY SUITE # 5
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City | CARMICHAEL
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State | CA
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Zip | 95608-1379
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Country | US
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Telephone | 916-480-0506
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Fax | 916-480-0609
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Authorized Official
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Title or Position | M.D.
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Name | ABRHAM TEKOLA
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Credential |
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Telephone | 916-480-0506
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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 | 332952
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License Number State | CA
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