Provider Demographics
NPI:1720200017
Name:ABALOS, ANNA TZEITEL PASCUAL (MD)
Entity Type:Individual
Prefix:
First Name:ANNA TZEITEL
Middle Name:PASCUAL
Last Name:ABALOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNA TZEITEL
Other - Middle Name:CASTANEDA
Other - Last Name:PASCUAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:701 PLEASANT GROVE BLVD
Mailing Address - Street 2:STE 125
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-6194
Mailing Address - Country:US
Mailing Address - Phone:916-624-0300
Mailing Address - Fax:916-624-0631
Practice Address - Street 1:701 PLEASANT GROVE BLVD STE 125
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-6194
Practice Address - Country:US
Practice Address - Phone:916-624-0300
Practice Address - Fax:916-624-0631
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99031207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine