Provider Demographics
NPI:1447879234
Name:AKBARIAN, CORRY
Entity type:Individual
Prefix:
First Name:CORRY
Middle Name:
Last Name:AKBARIAN
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 1:1313 GLENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-1513
Mailing Address - Country:US
Mailing Address - Phone:925-323-2720
Mailing Address - Fax:
Practice Address - Street 1:1313 GLENWOOD DR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-1513
Practice Address - Country:US
Practice Address - Phone:925-323-2720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-11
Last Update Date:2020-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered