Provider Demographics
NPI:1689998817
Name:ABRAHAM INTERNATIONAL
Entity Type:Organization
Organization Name:ABRAHAM INTERNATIONAL
Other - Org Name:ENERGYCENTER.COM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:C
Authorized Official - Middle Name:JON
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:415-474-3628
Mailing Address - Street 1:2263 SACRAMENTO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2326
Mailing Address - Country:US
Mailing Address - Phone:415-474-3628
Mailing Address - Fax:
Practice Address - Street 1:2263 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2326
Practice Address - Country:US
Practice Address - Phone:415-474-3628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332B00000X332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies