Provider Demographics
NPI:1205933249
Name:ABBA I. TERR, M.D. & LENORE C. TERR, M.D., A MEDICAL CORPORATION
Entity type:Organization
Organization Name:ABBA I. TERR, M.D. & LENORE C. TERR, M.D., A MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSGROVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-644-7040
Mailing Address - Street 1:450 SUTTER ST
Mailing Address - Street 2:SUITE 2534
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4206
Mailing Address - Country:US
Mailing Address - Phone:415-433-7800
Mailing Address - Fax:415-433-2130
Practice Address - Street 1:450 SUTTER ST
Practice Address - Street 2:SUITE 2534
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4206
Practice Address - Country:US
Practice Address - Phone:415-433-7800
Practice Address - Fax:415-433-2130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G192510207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID NUMBER