Provider Demographics
NPI:1508433772
Name:ALMUKHTAR, AYA
Entity Type:Individual
Prefix:
First Name:AYA
Middle Name:
Last Name:ALMUKHTAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3635 E 1ST ST APT 308
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-2737
Mailing Address - Country:US
Mailing Address - Phone:949-439-6516
Mailing Address - Fax:
Practice Address - Street 1:2510 MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-3581
Practice Address - Country:US
Practice Address - Phone:310-893-1978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program