Provider Demographics
NPI:1710255591
Name:AKHTAR, EHSAAN (MD)
Entity Type:Individual
Prefix:
First Name:EHSAAN
Middle Name:
Last Name:AKHTAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 E ALMOND AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-5562
Mailing Address - Country:US
Mailing Address - Phone:559-673-4000
Mailing Address - Fax:559-673-3661
Practice Address - Street 1:451 E ALMOND AVE STE 103
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-5562
Practice Address - Country:US
Practice Address - Phone:559-673-4000
Practice Address - Fax:559-673-3661
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA133960207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology