Healthcare Provider Details

I. General information

NPI: 1285435388
Provider Name (Legal Business Name): ALI SHARIFZADEH
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

242 CRANBROOK GDNS SE
CALGARY AB
T3M 3N6
CA

IV. Provider business mailing address

242 CRANBROOK GDNS SE
CALGARY AB
T3M 3N6
CA

V. Phone/Fax

Practice location:
  • Phone: 714-920-2838
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: