Provider Demographics
NPI:1780790402
Name:AKIN, MICHAEL ANGELO (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANGELO
Last Name:AKIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8829 SHELDON RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-5043
Mailing Address - Country:US
Mailing Address - Phone:916-688-1168
Mailing Address - Fax:916-688-1168
Practice Address - Street 1:8829 SHELDON RD
Practice Address - Street 2:SUITE 110
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-5043
Practice Address - Country:US
Practice Address - Phone:916-688-1168
Practice Address - Fax:916-688-1168
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15574111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0155740Medicare ID - Type Unspecified