MEDICARE: DR. ASHMEAD ALI MD

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	207R00000X	Internal Medicine Physician	G78625	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215009113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHMEAD ALI MD

Provider Business Mailing Address
First Line	:	41019 WOODSHIRE DR
Second Line	:
City	:	PALMDALE
State	:	CA
Zip	:	93551-5746
Country	:	US
Telephone Number	:	760-373-1256
Fax Number	:	760-373-1214

Provider Business Practice Location Address
First Line	:	9300 N LOOP BLVD
Second Line	:	SUITE A & B
City	:	CALIFORNIA CITY
State	:	CA
Zip	:	93505-2269
Country	:	US
Telephone Number	:	760-373-1256
Fax Number	:	760-373-1214

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	12/01/2011

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