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ABOLGHASEM ABDOLI MD

>> Pediatrics >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1790757441

Individual Registrant:
 ABOLGHASEM  ABDOLI MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
751 S BASCOM AVE PEDIATRICS DEPT SAN JOSE, CA 95128-2604 US
Tel: 408-885-6616  Fax: --

Contact information for business:
751 S BASCOM AVE PEDIATRICS SAN JOSE, CA 95128-2604 US
Tel: 408-885-0000  Fax: --

Registration Information:
NPI: 1790757441
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
X208000000XAllopathic & Osteopathic Physicians
Pediatrics
CAA49572
X2080N0001XAllopathic & Osteopathic Physicians
Pediatrics
CAA49572

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
00A495720CA05




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