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General NPI Number Information
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NPI Number | 1487151759
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Entity Type | Individual
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Provider Name | AKANKSHA MOHAN
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Gender | Female
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 1433 N 1075 W STE 104
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City | FARMINGTON
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State | UT
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Zip | 84025-2746
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Country | US
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Telephone | 12-981-3008
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Fax |
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Provider Business Mailing Address
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Address Line | 2191 S MCCLELLAND ST
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City | SALT LAKE CITY
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State | UT
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Zip | 84106-3054
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Country | US
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Telephone | 757-232-0213
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD210011614
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License Number State | DC
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