Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC36160 | CA |
NPI | 1265103147 |
---|---|
Provider Name | Zeina Abouakl |
First Address | Upland, CA 91786-3575 |
Second Address | Upland, CA 91786-3577 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2021 |
Last Update Date | 01/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1265103147 | CHIROPRACTIC (01) | |
NONE | NON PARTICIPATING CHIROPRACTIC OFFICE (01) |