Provider Demographics
NPI:1861448599
Name:AKONG, MICHAEL ANTHONY (MPH, LAC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:AKONG
Suffix:
Gender:M
Credentials:MPH, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:14356 MARIANOPOLIS WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-4316
Mailing Address - Country:US
Mailing Address - Phone:858-484-5405
Mailing Address - Fax:858-484-7514
Practice Address - Street 1:2738 LOKER AVE W
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010-6629
Practice Address - Country:US
Practice Address - Phone:858-837-2830
Practice Address - Fax:858-484-7514
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC8137171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist