Provider Demographics
NPI:1720646011
Name:ABRAHAM M BETRE DO, INC
Entity Type:Organization
Organization Name:ABRAHAM M BETRE DO, INC
Other - Org Name:ABRAHAM M BETRE DO, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BETRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-688-6400
Mailing Address - Street 1:925 E MERRITT AVE
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-2221
Mailing Address - Country:US
Mailing Address - Phone:559-688-6400
Mailing Address - Fax:559-688-6500
Practice Address - Street 1:925 E MERRITT AVE
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-2221
Practice Address - Country:US
Practice Address - Phone:559-688-6400
Practice Address - Fax:559-688-6500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-31
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYH76769Medicaid