Healthcare Provider Details

I. General information

NPI: 1982264230
Provider Name (Legal Business Name): ALINA HAIDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2019
Last Update Date: 12/27/2022
Certification Date: 07/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1448 FLORIDA AVE
MODESTO CA
95350-4424
US

IV. Provider business mailing address

1448 FLORIDA AVE
MODESTO CA
95350-4424
US

V. Phone/Fax

Practice location:
  • Phone: 209-523-1884
  • Fax:
Mailing address:
  • Phone: 209-523-1884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA179914
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: