Provider Demographics
NPI:1447200761
Name:ABACI, PETER (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:ABACI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15047 LOS GATOS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2054
Mailing Address - Country:US
Mailing Address - Phone:408-364-6799
Mailing Address - Fax:408-378-4510
Practice Address - Street 1:15047 LOS GATOS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2054
Practice Address - Country:US
Practice Address - Phone:408-364-6799
Practice Address - Fax:408-378-4510
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG76565207L00000X, 208VP0014X, 208VP0000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG34874Medicare UPIN
CA00G765651Medicare PIN
CA00G765650Medicaid
CAG34874Medicare UPIN