Provider Demographics
NPI:1124367420
Name:AKHCHIN, SAMI NGO (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:SAMI
Middle Name:NGO
Last Name:AKHCHIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SHRADER ST STE 578
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1034
Mailing Address - Country:US
Mailing Address - Phone:415-876-5762
Mailing Address - Fax:
Practice Address - Street 1:1 SHRADER ST STE 578
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1034
Practice Address - Country:US
Practice Address - Phone:415-876-5762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2871363AM0700X
CA51556363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant