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General NPI Number Information
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NPI Number | 1689451114
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Entity Type | Organization
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Legal Business Name | ALI ABIDALI DO PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 09/08/2023
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 500 N EUCLID AVE
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City | UPLAND
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State | CA
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Zip | 91786-4734
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Country | US
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Telephone | 909-757-8425
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Fax | 909-757-8392
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Provider Business Mailing Address
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Address Line | 154A W FOOTHILL BLVD # 372
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City | UPLAND
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State | CA
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Zip | 91786-3847
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALI ABIDALI
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Credential | DO
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Telephone | 480-251-5441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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