MEDICARE: DR. ALI TABRIZZI TAJLIL M.D.

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	2086S0129X	Vascular Surgery Physician	A378470	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	:	1861579534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALI TABRIZZI TAJLIL M.D.

Provider Business Mailing Address
First Line	:	3941 J ST
Second Line	:	SUITE 370
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-3628
Country	:	US
Telephone Number	:	916-733-6890
Fax Number	:	916-733-6849

Provider Business Practice Location Address
First Line	:	3941 J ST
Second Line	:	SUITE 370
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-3624
Country	:	US
Telephone Number	:	916-733-6890
Fax Number	:	916-733-6849

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	02/22/2012

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