Healthcare Provider Details

I. General information

NPI: 1598741639
Provider Name (Legal Business Name): CYNTHIA ROSEMARY ALLI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 11/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5342 DUDLEY BLVD BLDG #98 11C-3
MCCLELLAN CA
95652-1012
US

IV. Provider business mailing address

3905 EL RICON WAY
SACRAMENTO CA
95864-3043
US

V. Phone/Fax

Practice location:
  • Phone: 916-561-7520
  • Fax: 916-561-7529
Mailing address:
  • Phone: 916-240-4613
  • Fax: 916-561-7529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG069897
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: