Provider Demographics
NPI:1427157809
Name:ABRAMS, VICTOR (DC)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:
Last Name:ABRAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 934
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:CA
Mailing Address - Zip Code:93926-0934
Mailing Address - Country:US
Mailing Address - Phone:831-675-8711
Mailing Address - Fax:831-675-8711
Practice Address - Street 1:601 ELKO ST
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:CA
Practice Address - Zip Code:93926-0934
Practice Address - Country:US
Practice Address - Phone:831-675-8711
Practice Address - Fax:831-675-8711
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14865111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC148650Medicare PIN