Provider Demographics
NPI:1750304101
Name:PIRAMOON, ABE M (MD)
Entity Type:Individual
Prefix:
First Name:ABE
Middle Name:M
Last Name:PIRAMOON
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2505 SAMARITAN DRIVE
Mailing Address - Street 2:STE 508
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124
Mailing Address - Country:US
Mailing Address - Phone:408-356-1123
Mailing Address - Fax:408-356-0282
Practice Address - Street 1:2505 SAMARITAN DRIVE
Practice Address - Street 2:STE 508
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124
Practice Address - Country:US
Practice Address - Phone:408-356-1123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA365692086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A88384Medicare UPIN