Provider Demographics
NPI:1740907476
Name:IBRAHIM AKKARI DPM
Entity type:Organization
Organization Name:IBRAHIM AKKARI DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:IBRAHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:AKKARI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:657-254-6061
Mailing Address - Street 1:915 WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-2237
Mailing Address - Country:US
Mailing Address - Phone:657-254-6061
Mailing Address - Fax:
Practice Address - Street 1:25213 LEMONGRASS ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92883-3115
Practice Address - Country:US
Practice Address - Phone:657-254-6061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty