Provider Demographics
NPI:1144095894
Name:AKBARI, ISSA M
Entity type:Individual
Prefix:
First Name:ISSA
Middle Name:M
Last Name:AKBARI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 MOUNT PELLIER ST
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95304-5945
Mailing Address - Country:US
Mailing Address - Phone:925-724-3149
Mailing Address - Fax:
Practice Address - Street 1:1813 MOUNT PELLIER ST
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95304-5945
Practice Address - Country:US
Practice Address - Phone:925-724-3149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedHome Health
No171W00000XOther Service ProvidersContractor