Healthcare Provider Details

I. General information

NPI: 1073757712
Provider Name (Legal Business Name): MUHAMMAD ALI RDCS (AE)
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2009
Last Update Date: 04/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3919 BEVERLY BLVD SUITE 201
LOS ANGELES CA
90004-3432
US

IV. Provider business mailing address

3919 BEVERLY BLVD SUITE 201
LOS ANGELES CA
90004-3432
US

V. Phone/Fax

Practice location:
  • Phone: 310-648-0665
  • Fax:
Mailing address:
  • Phone: 310-648-0665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number131861
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: