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General NPI Number Information
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NPI Number | 1376722736
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Entity Type | Individual
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Provider Name | ALTAF LUTFE ALI M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2007
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 5365 WALNUT AVE STE. L
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City | CHINO
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State | CA
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Zip | 91710-2622
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Country | US
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Telephone | 909-591-7395
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Fax | 909-591-5097
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Provider Business Mailing Address
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Address Line | 5365 WALNUT AVE STE. L
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City | CHINO
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State | CA
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Zip | 91710-2622
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Country | US
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Telephone | 909-591-7395
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Fax | 909-591-5097
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A42679
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | A42679
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License Number State | CA
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