Provider Demographics
NPI:1558332999
Name:OSHTORY, ABHA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ABHA
Middle Name:M
Last Name:OSHTORY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 N CALIFORNIA ST
Mailing Address - Street 2:SUITE I
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-5500
Mailing Address - Country:US
Mailing Address - Phone:209-944-5733
Mailing Address - Fax:209-944-0129
Practice Address - Street 1:2626 N CALIFORNIA ST
Practice Address - Street 2:SUITE I
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-5500
Practice Address - Country:US
Practice Address - Phone:209-944-5733
Practice Address - Fax:209-944-0129
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0261982084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A261980Medicaid
A24767Medicare UPIN
YYY49171YMedicare ID - Type Unspecified