Healthcare Provider Details

I. General information

NPI: 1619119278
Provider Name (Legal Business Name): CHRISTOPHER DAVID AKE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2009
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2374 E PACIFICA PL
RANCHO DOMINGUEZ CA
90220-6214
US

IV. Provider business mailing address

2374 E PACIFICA PL STE 301
RANCHO DOMINGUEZ CA
90220-6214
US

V. Phone/Fax

Practice location:
  • Phone: 310-225-3221
  • Fax: 310-698-7040
Mailing address:
  • Phone: 310-225-3221
  • Fax: 310-698-7040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number20A11579
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberDO1882
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number006473
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number20A11579
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number20A11579
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: