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General NPI Number Information
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NPI Number | 1558462515
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Entity Type | Individual
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Provider Name | MOHAMMAD ALI AKBARI PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 04/19/2013
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Provider Practice Location Address
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Address Line | 24853 ALESSANDRO BLVD
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City | MORENO VALLEY
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State | CA
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Zip | 92553-6102
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Country | US
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Telephone | 951-571-8518
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Fax | 562-485-7748
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Provider Business Mailing Address
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Address Line | 200 OCEANGATE SUITE 100
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City | LONG BEACH
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State | CA
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Zip | 90802-4302
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Country | US
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Telephone | 562-499-6191
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Fax | 562-499-6171
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA17622
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA17622
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License Number State | CA
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