Provider Demographics
NPI:1992931067
Name:TIRONA, ABRAM PAGTAKHAN (MD)
Entity type:Individual
Prefix:DR
First Name:ABRAM
Middle Name:PAGTAKHAN
Last Name:TIRONA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2127 OLYMPIC PKWY STE 1006-344
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91915-1359
Mailing Address - Country:US
Mailing Address - Phone:530-431-8494
Mailing Address - Fax:
Practice Address - Street 1:2127 OLYMPIC PKWY STE 1006-344
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-1359
Practice Address - Country:US
Practice Address - Phone:530-431-8494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA132609208D00000X
PAMT196553390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice