Healthcare Provider Details

I. General information

NPI: 1144996281
Provider Name (Legal Business Name): AKASH SELVAM BACHELORS OF SCIENCE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42603 HAMILTON WAY
FREMONT CA
94538-5534
US

IV. Provider business mailing address

42603 HAMILTON WAY
FREMONT CA
94538-5534
US

V. Phone/Fax

Practice location:
  • Phone: 510-676-6979
  • Fax:
Mailing address:
  • Phone: 510-676-6979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: