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1407981731 NPI number — MOHAMED S ALI MD PROFESSIONAL CORPORATION

NPI Number: 1407981731
Health Care Provider/Practitioner: MOHAMED S ALI MD PROFESSIONAL CORPORATION

Information about “1407981731” NPI (MOHAMED S ALI MD PROFESSIONAL CORPORATION) exists in 1407981731 in HTML format HTML  |  1407981731 in plain Text format TXT  |  1407981731 in PDF (Portable Document Format) PDF  |  1407981731 in an XML format XML  formats.

NPI Number : 1407981731 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1407981731",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MOHAMED S ALI MD PROFESSIONAL CORPORATION",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "10165 FOOTHILL BLVD",
    "SecondLineMailingAddress": "#26",
    "MailingAddressCityName": "RANCHO CUCAMONGA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91730-0340",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "909-481-0800",
    "MailingAddressFaxNumber": "909-481-0700",
    "FirstLinePracticeLocationAddress": "10165 FOOTHILL BLVD",
    "SecondLinePracticeLocationAddress": "#26",
    "PracticeLocationAddressCityName": "RANCHO CUCAMONGA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91730-0340",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "909-481-0800",
    "PracticeLocationAddressFaxNumber": "909-481-0700",
    "EnumerationDate": "02/23/2007",
    "LastUpdateDate": "06/25/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ALI",
    "AuthorizedOfficialFirstName": "MOHAMED",
    "AuthorizedOfficialMiddleName": "S",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "909-732-2732",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207R00000X",
        "TaxonomyName": "Internal Medicine Physician",
        "LicenseNumber": "A67534",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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