Individual
ANITA ABRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2545 W HAMMER LN, STOCKTON, CA 95209-2839
(209) 943-2041
(209) 473-9365
Mailing address
10470 OLD PLACERVILLE RD STE 100, SACRAMENTO, CA 95827-2539
(800) 470-0071
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
C142479
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200377620A
—
KS
05
—
200704807
—
MO
05
—
500705761
—
OR
Enumeration date
07/19/2006
Last updated
08/09/2019
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