Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 39226 | CA |
NPI | 1023137478 |
---|---|
Provider Name | Jay Akef |
First Address | San Diego, CA 92117-5479 |
Second Address | San Diego, CA 92117-5479 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 23/03/2016 |