Healthcare Provider Details
I. General information
NPI: 1740907476
Provider Name (Legal Business Name): IBRAHIM AKKARI DPM
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/24/2022
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
301 S FAIR OAKS AVE STE 207
PASADENA CA
91105-2562
US
IV. Provider business mailing address
301 S FAIR OAKS AVE STE 207
PASADENA CA
91105-2562
US
V. Phone/Fax
- Phone: 337-315-7927
- Fax: 626-405-1037
- Phone: 337-315-7927
- Fax: 626-405-1037
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
IBRAHIM
AKKARI
Title or Position: CEO
Credential: DPM
Phone: 337-315-7927