Healthcare Provider Details

I. General information

NPI: 1396399986
Provider Name (Legal Business Name): ALI ANARI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2019
Last Update Date: 06/14/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 N MACLAY AVE
SAN FERNANDO CA
91340-2906
US

IV. Provider business mailing address

107 N MACLAY AVE
SAN FERNANDO CA
91340-2906
US

V. Phone/Fax

Practice location:
  • Phone: 818-697-8585
  • Fax:
Mailing address:
  • Phone: 818-697-8585
  • Fax: 888-799-8585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ALI ANARI
Title or Position: CEO
Credential: MD
Phone: 310-210-0001