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General NPI Number Information
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NPI Number | 1861875429
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Entity Type | Individual
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Provider Name | ALI POURDJABBAR MD
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Gender | Male
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Dates
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Enumeration Date | 07/01/2015
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Last Update Date | 07/01/2015
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Provider Practice Location Address
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Address Line | 9434 MEDICAL CENTER DRIVE UC SAN DIEGO DIVISION OF CARDIOVASCULAR MEDICINEC
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City | LA JOLLA
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State | CA
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Zip | 92037
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Country | US
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Telephone | 858-657-5378
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Fax |
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Provider Business Mailing Address
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Address Line | 3535 LEBON DR APT 2301
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City | SAN DIEGO
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State | CA
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Zip | 92122-4595
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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 |
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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 | A134134
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License Number State | CA
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