Provider Demographics
NPI:1932514874
Name:ABRAHAM, JERRY PUTHENPURAKAL (MD, MPH, CMQ)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:PUTHENPURAKAL
Last Name:ABRAHAM
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Gender:M
Credentials:MD, MPH, CMQ
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Mailing Address - Street 1:1400 S GRAND AVE STE 703
Mailing Address - Street 2:USC-CHMC FAMILY MEDICINE RESIDENCY PROGRAM
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-3068
Mailing Address - Country:US
Mailing Address - Phone:213-741-1106
Mailing Address - Fax:213-741-1434
Practice Address - Street 1:1400 S GRAND AVE STE 703
Practice Address - Street 2:USC-CHMC FAMILY MEDICINE RESIDENCY PROGRAM
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3068
Practice Address - Country:US
Practice Address - Phone:213-741-1106
Practice Address - Fax:213-741-1434
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2020-03-27
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Provider Licenses
StateLicense IDTaxonomies
CA141443208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice