Provider Demographics
NPI:1508961582
Name:ABELES, DOUGLAS J (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:J
Last Name:ABELES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:21030 REDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5920
Mailing Address - Country:US
Mailing Address - Phone:510-538-0430
Mailing Address - Fax:510-538-1839
Practice Address - Street 1:21030 REDWOOD RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5920
Practice Address - Country:US
Practice Address - Phone:510-538-0430
Practice Address - Fax:510-538-1839
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG79953207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFM288YOtherMEDICARE PTAN