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General NPI Number Information
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NPI Number | 1437851276
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Entity Type | Organization
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Legal Business Name | PT & WELLNESS OF CALIFORNIA MSO, LLC
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Dates
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Enumeration Date | 03/17/2023
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 6833 STOCKTON BLVD STE 430
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City | SACRAMENTO
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State | CA
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Zip | 95823-2373
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Country | US
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Telephone | 248-937-0370
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Fax |
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Provider Business Mailing Address
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Address Line | 6833 STOCKTON BLVD STE 430
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City | SACRAMENTO
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State | CA
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Zip | 95823-2373
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Country | US
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Telephone | 248-937-0370
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TOMAS E ABRAHAM
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Credential | MPT
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Telephone | 310-980-0904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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