Provider Demographics
NPI:1427462175
Name:ADNAN AKHTAR D.O. INC
Entity type:Organization
Organization Name:ADNAN AKHTAR D.O. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ADNAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AKHTAR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:734-652-8300
Mailing Address - Street 1:1590 ADAMS AVE UNIT 2882
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92628-4873
Mailing Address - Country:US
Mailing Address - Phone:734-652-8300
Mailing Address - Fax:
Practice Address - Street 1:301 VICTORIA ST
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-1995
Practice Address - Country:US
Practice Address - Phone:949-642-2734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9286207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1215126396Medicare UPIN