MEDICARE: DR. ALI ADNAN ALI'I'KAI SADDUK D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	57006	CA

General Provider Information

NPI Number	:	1144487679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALI ADNAN ALI'I'KAI SADDUK D.D.S.

Provider Business Mailing Address
First Line	:	11183 SCRIPPS RANCH BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92131-2410
Country	:	US
Telephone Number	:	310-430-8118
Fax Number	:

Provider Business Practice Location Address
First Line	:	11183 SCRIPPS RANCH BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92131-2410
Country	:	US
Telephone Number	:	310-430-8118
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	05/11/2012

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