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General NPI Number Information
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NPI Number | 1992102420
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Entity Type | Individual
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Provider Name | REBECCA M. AKOLO D.P.M
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Gender | Female
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Dates
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Enumeration Date | 11/26/2014
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Last Update Date | 11/26/2014
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Provider Practice Location Address
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Address Line | 25279 TAYLOR ST UNIT A
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City | LOMA LINDA
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State | CA
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Zip | 92354-3054
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Country | US
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Telephone | 510-528-9609
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Fax |
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Provider Business Mailing Address
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Address Line | 25279 TAYLOR ST UNIT A
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City | LOMA LINDA
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State | CA
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Zip | 92354-3054
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Country | US
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Telephone | 510-289-6090
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 6707
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License Number State | CA
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