Provider Demographics
NPI:1245803055
Name:AKBAR, NEELA (PA-C)
Entity Type:Individual
Prefix:
First Name:NEELA
Middle Name:
Last Name:AKBAR
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 1:5201 LAGUNA OAKS DR UNIT 32
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7319
Mailing Address - Country:US
Mailing Address - Phone:916-753-9470
Mailing Address - Fax:
Practice Address - Street 1:5201 LAGUNA OAKS DR UNIT 32
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-7319
Practice Address - Country:US
Practice Address - Phone:916-753-9470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363A00000X
CAPA60196363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant