Provider Demographics
NPI:1225763667
Name:ABON, TINO ORLANDO JR (DC)
Entity Type:Individual
Prefix:DR
First Name:TINO
Middle Name:ORLANDO
Last Name:ABON
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 PETALUMA BLVD N STE B9
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-3051
Mailing Address - Country:US
Mailing Address - Phone:925-300-8484
Mailing Address - Fax:
Practice Address - Street 1:6 PETALUMA BLVD N STE B9
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-3051
Practice Address - Country:US
Practice Address - Phone:925-300-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor