Organization
AKOS MD IPA LLC
Active
Other names
N/A
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAN NHU BICH PHAN (ADMINISTRATOR)
(818) 399-8996
Entity
Organization
Contact information
Practice address
20565 N 19TH AVE, PHOENIX, AZ 85027-3563
(818) 399-8996
(866) 627-3093
Mailing address
2391 CATHERINE RD, ALTADENA, CA 91001-2334
(818) 399-8996
(866) 627-3093
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
11/11/2019
Last updated
11/11/2019
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