MEDICARE: DR. MAHER ALI ABDALLAH 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	174400000X	Specialist	C52107	CA

General Provider Information

NPI Number	:	1205988011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAHER ALI ABDALLAH M.D.

Provider Business Mailing Address
First Line	:	1199 N INDIAN CANYON DR STE A
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-4836
Country	:	US
Telephone Number	:	760-346-4334
Fax Number	:	760-346-3663

Provider Business Practice Location Address
First Line	:	1199 N INDIAN CANYON DR
Second Line	:	STE. A
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-4836
Country	:	US
Telephone Number	:	760-346-4334
Fax Number	:	760-346-3663

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

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	12/14/2012

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