MEDICARE: DR. JENNIFER JANE ABRAHAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	G63721	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285650259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER JANE ABRAHAM MD

Provider Business Mailing Address
First Line	:	PO BOX 2507
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93303-2507
Country	:	US
Telephone Number	:	661-335-7755
Fax Number	:	661-335-7766

Provider Business Practice Location Address
First Line	:	3838 SAN DIMAS ST STE A100
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-2286
Country	:	US
Telephone Number	:	661-324-4963
Fax Number	:	661-327-5432

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	01/15/2013

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