Provider Demographics
NPI:1356313035
Name:ABDENOUR, THOMAS ESSE (ATC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ESSE
Last Name:ABDENOUR
Suffix:
Gender:M
Credentials:ATC
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Mailing Address - Street 1:14644 OUTRIGGER DR
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-6413
Mailing Address - Country:US
Mailing Address - Phone:510-483-0920
Mailing Address - Fax:510-452-0238
Practice Address - Street 1:1011 BROADWAY
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4019
Practice Address - Country:US
Practice Address - Phone:510-986-2268
Practice Address - Fax:510-452-0238
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer