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Abram Estafanous

Psychiatry & Neurology

Allopathic & Osteopathic Physicians

3020 Childrens Way # 5018, San Diego, CA 92123-4223

PECOS Enrollment

Based on the most recent information from CMS, provider Abram Estafanous is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:51 AM.

Profile Details

Provider ID
1528647724
Provider Type
Individual
Full Name
Estafanous, Abram
Credential
DO

Gender
Male
Sole Proprietor
No
Enumeration Date
4/5/2021
Last Updated
2/14/2025

Contact Information

Practice Location

3020 Childrens Way # 5018, San Diego, CA 92123-4223

(858) 576-1700

Unlisted Fax

Mailing Location

3020 Childrens Way # 5018, San Diego, CA 92123-4223

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2084P0804X Primary	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License 20A20585 California
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Abram Estafanous

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Johnson, Brett

Feriante, Joshua

Gildin, Joan Sandra

Brar, Simerjeet K.

Masillamoni, Stephen Ranjit

Grozavu, Sergiu

Tung, Eric Yuanker

Solway, Karen E

Heyneman, Ellen K

Yoo, Bo Ram