Provider Demographics
NPI:1053386565
Name:BETRE, ABRAHAM N (MD, INC)
Entity type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:N
Last Name:BETRE
Suffix:
Gender:M
Credentials:MD, INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 E. MERRITT AVENUE
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274
Mailing Address - Country:US
Mailing Address - Phone:559-688-6400
Mailing Address - Fax:559-688-6500
Practice Address - Street 1:925 E. MERRITT AVENUE
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274
Practice Address - Country:US
Practice Address - Phone:559-688-6400
Practice Address - Fax:559-688-6500
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-19
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10290207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSH76769Medicare UPIN
CA020A102900Medicare PIN