Provider Demographics
NPI:1184860264
Name:AKOSAH, KWADWO
Entity Type:Individual
Prefix:MS
First Name:KWADWO
Middle Name:
Last Name:AKOSAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9150 IMPERIAL HWY RM P.31
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-2835
Mailing Address - Country:US
Mailing Address - Phone:562-940-3694
Mailing Address - Fax:562-658-7425
Practice Address - Street 1:9150 IMPERIAL HWY RM P.31
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2835
Practice Address - Country:US
Practice Address - Phone:562-940-3694
Practice Address - Fax:562-658-7425
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA171M00000XOtherOTHER SERVICE PROVIDERS