Healthcare Provider Details

I. General information

NPI: 1205684867
Provider Name (Legal Business Name): AL MECCA ALI AKBAR MUHAMMAD BEY J.L.ESQ., PHD.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: HONORABLE AL BEY J.L.ESQ. ,PHD.

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 SOMERSET BLVD UNIT 982
PARAMOUNT CA
90723-8748
US

IV. Provider business mailing address

7200 SOMERSET BLVD UNIT 982
PARAMOUNT CA
90723-8748
US

V. Phone/Fax

Practice location:
  • Phone: 518-217-8529
  • Fax:
Mailing address:
  • Phone: 518-217-8529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282J00000X
TaxonomyReligious Nonmedical Health Care Institution
License Number282J00000X
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: