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General NPI Number Information
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NPI Number | 1942578943
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Entity Type | Organization
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Legal Business Name | CAL CITY CLINIC
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Dates
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Enumeration Date | 12/05/2011
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Last Update Date | 01/06/2012
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Provider Practice Location Address
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Address Line | 9300 N LOOP BLVD STE A&B
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City | CALIFORNIA CITY
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State | CA
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Zip | 93505-2269
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Country | US
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Telephone | 760-373-1256
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Fax | 760-373-1214
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Provider Business Mailing Address
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Address Line | 41019 WOODSHIRE DR
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City | PALMDALE
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State | CA
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Zip | 93551-5746
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Country | US
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Telephone | 661-547-3906
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Fax | 661-622-4257
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Authorized Official
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Title or Position | OWNER
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Name | MR. ASHMEAD ALI
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Credential | MD
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Telephone | 661-547-3906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | G78625
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License Number State | CA
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