Healthcare Provider Details

I. General information

NPI: 1740422427
Provider Name (Legal Business Name): KNIGHT MD INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2009
Last Update Date: 03/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 SIR FRANCIS DRAKE BLVD
KENTFIELD CA
94904-1418
US

IV. Provider business mailing address

31566 RAILROAD CANYON RD 2-130
CANYON LAKE CA
92587-9446
US

V. Phone/Fax

Practice location:
  • Phone: 877-870-9301
  • Fax: 877-882-0462
Mailing address:
  • Phone: 877-870-9301
  • Fax: 877-882-0462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberC52438
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberC52438
License Number StateCA

VIII. Authorized Official

Name: DR. MOHAMMED SAMI AKRAM
Title or Position: PRESIDENT
Credential: M.D.
Phone: 877-870-9301