Healthcare Provider Details

I. General information

NPI: 1124384110
Provider Name (Legal Business Name): ALI ASGHAR TORBATI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 W MACARTHUR BLVD
OAKLAND CA
94611
US

IV. Provider business mailing address

275 W MACARTHUR BLVD
OAKLAND CA
94611-5641
US

V. Phone/Fax

Practice location:
  • Phone: 510-914-0759
  • Fax: 510-675-5500
Mailing address:
  • Phone: 510-914-0759
  • Fax: 510-675-5500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberA133799
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberA133799
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: