Doctor Name: | ALI H REZA |
NPI Number: | 1598723538 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 09458R |
Business Practice Address: | 2141 Colorado Ave Turlock, CA - 953822011 |
Business Phone Number: | 2096342600 |
Business Fax Number: | 2095754598 |
Mailing Address: | Po Box 4398, MODESTO |
State: | CA |
Postal Code: | 953524398 |
Phone Number: | 2095754575 |
Fax Number: | 2095754575 |
NPI Enumeration Date: | 05/01/2006 |
NPI Last Update Date: | 07/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 09458R |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |