MEDICARE: DR. ALI JADALI-ARAGHI D.M.D

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	58835	CA

General Provider Information

NPI Number	:	1174857932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALI JADALI-ARAGHI D.M.D

Provider Business Mailing Address
First Line	:	7597 MONA LN
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92130-5619
Country	:	US
Telephone Number	:	858-688-3989
Fax Number	:

Provider Business Practice Location Address
First Line	:	7597 MONA LN
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92130-5619
Country	:	US
Telephone Number	:	858-688-3989
Fax Number	:

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

Provider Enumeration Date	:	09/28/2009
Last Update Date	:	09/28/2009

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