Healthcare Provider Details

I. General information

NPI: 1235795089
Provider Name (Legal Business Name): ALA MUSTAFA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2019
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 6TH AVE
DES MOINES IA
50314-2613
US

IV. Provider business mailing address

621 S ILLINOIS AVE STE 103
MASON CITY IA
50401-5489
US

V. Phone/Fax

Practice location:
  • Phone: 515-247-3121
  • Fax:
Mailing address:
  • Phone: 641-428-6900
  • Fax: 641-428-6909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD-48878
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR-11461
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberW6508
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: