Basic Information
| Provider Information | |||||||||
| NPI: | 1932598364 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AKMD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1441 AVOCADO AVE | ||||||||
| Address2: | SUITE 308 | ||||||||
| City: | NEWPORT BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926607721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9497210494 | ||||||||
| FaxNumber: | 9497214138 | ||||||||
| Practice Location | |||||||||
| Address1: | 35 E GLENARM ST | ||||||||
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| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911053418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6267684415 | ||||||||
| FaxNumber: | 6264030321 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2015 | ||||||||
| LastUpdateDate: | 01/22/2015 | ||||||||
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| AuthorizedOfficialLastName: | KOSINS | ||||||||
| AuthorizedOfficialFirstName: | AARON | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9497210494 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0122X | A107134 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Plastic and Reconstructive Surgery |
No ID Information.