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General NPI Number Information
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NPI Number | 1407981731
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Entity Type | Organization
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Legal Business Name | MOHAMED S ALI MD PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 06/25/2020
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Provider Practice Location Address
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Address Line | 10165 FOOTHILL BLVD #26
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-0340
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Country | US
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Telephone | 909-481-0800
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Fax | 909-481-0700
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Provider Business Mailing Address
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Address Line | 10165 FOOTHILL BLVD #26
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-0340
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Country | US
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Telephone | 909-481-0800
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Fax | 909-481-0700
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMED S ALI
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Credential | MD
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Telephone | 909-732-2732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A67534
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License Number State | CA
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