1457642191 NPI number — DR. LYNN CHERYL AKIONA D044773

Table of content: DR. LYNN CHERYL AKIONA D044773 (NPI 1457642191)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457642191 NPI number — DR. LYNN CHERYL AKIONA D044773

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AKIONA
Provider First Name:
LYNN
Provider Middle Name:
CHERYL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D044773
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
AKIONA
Provider Other First Name:
LYNN
Provider Other Middle Name:
CHERYL
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D044773
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1457642191
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/15/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
359 W MADISON AVE
Provider Second Line Business Mailing Address:
STE200
Provider Business Mailing Address City Name:
EL CAJON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92020-3455
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-440-6365
Provider Business Mailing Address Fax Number:
619-440-7629

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3639 MIDWAY DR
Provider Second Line Business Practice Location Address:
STE. B-136
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92110-5254
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-244-0880
Provider Business Practice Location Address Fax Number:
619-440-7629
Provider Enumeration Date:
04/28/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  044773 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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