Healthcare Provider Details

I. General information

NPI: 1902358575
Provider Name (Legal Business Name): BACHAR ALI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2016
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 MONTE VISTA AVE STE 190
CLAREMONT CA
91711-6600
US

IV. Provider business mailing address

1110 S 5TH AVE UNIT 239
MONROVIA CA
91016-3871
US

V. Phone/Fax

Practice location:
  • Phone: 909-865-9977
  • Fax: 94-692-1199
Mailing address:
  • Phone: 909-630-7868
  • Fax: 94-692-1099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A20287
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS020382
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: