Provider Demographics
NPI:1336122662
Name:UMAR, AKBAR (MD)
Entity Type:Individual
Prefix:
First Name:AKBAR
Middle Name:
Last Name:UMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 SAMUEL DR
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-6325
Mailing Address - Country:US
Mailing Address - Phone:530-674-9200
Mailing Address - Fax:530-674-5667
Practice Address - Street 1:334 SAMUEL DR
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-6325
Practice Address - Country:US
Practice Address - Phone:530-674-9200
Practice Address - Fax:530-674-5667
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63674208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
G72984Medicare UPIN