Provider Demographics
NPI:1144325242
Name:AKRAM, MUMTAZ (MD)
Entity type:Individual
Prefix:MR
First Name:MUMTAZ
Middle Name:
Last Name:AKRAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:906 S SUNSET AVE
Mailing Address - Street 2:STE 104
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3400
Mailing Address - Country:US
Mailing Address - Phone:626-960-9455
Mailing Address - Fax:626-960-0833
Practice Address - Street 1:906 S SUNSET AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3400
Practice Address - Country:US
Practice Address - Phone:626-960-9455
Practice Address - Fax:626-960-0833
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA34950207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA34950Medicare ID - Type Unspecified