MEDICARE: NADIA ALI RDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133N00000X	Nutritionist
2	133V00000X	Registered Dietitian	86211815	CA

General Provider Information

NPI Number	:	1164104055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADIA ALI RDN

Provider Business Mailing Address
First Line	:	1637 WILSON AVE
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91006-1828
Country	:	US
Telephone Number	:	626-818-3423
Fax Number	:

Provider Business Practice Location Address
First Line	:	1637 WILSON AVE
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91006-1828
Country	:	US
Telephone Number	:	626-818-3423
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2023
Last Update Date	:	09/30/2024

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