Provider Demographics
NPI:1750309936
Name:WEBER, ABRAHAM ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:ALAN
Last Name:WEBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5 BON AIR RD
Mailing Address - Street 2:# 127
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1143
Mailing Address - Country:US
Mailing Address - Phone:415-945-9065
Mailing Address - Fax:415-945-9062
Practice Address - Street 1:5 BON AIR RD
Practice Address - Street 2:# 127
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1143
Practice Address - Country:US
Practice Address - Phone:415-945-9065
Practice Address - Fax:415-945-9062
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG12812207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G128120Medicaid
CAA89175Medicare UPIN
CA00G128120Medicaid