Healthcare Provider Details

I. General information

NPI: 1699788240
Provider Name (Legal Business Name): ALI SABBAGHI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3392 MOTOR AVE
LOS ANGELES CA
90034-3712
US

IV. Provider business mailing address

3392 MOTOR AVE
LOS ANGELES CA
90034-3712
US

V. Phone/Fax

Practice location:
  • Phone: 310-202-1133
  • Fax: 310-202-1139
Mailing address:
  • Phone: 310-202-1133
  • Fax: 310-202-1139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberA69120
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: