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NPI Code Detail

MEDICARE: DR. TABASSUM ALI D.C.

MEDICARE: DR. TABASSUM ALI D.C.
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
1111NS0005XSports Physician Chiropractor32556CA

General Provider Information

NPI Number : 1316287642
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TABASSUM ALI D.C.
Provider Business Mailing Address
First Line : 234 6TH ST
Second Line : APT 2
City : SEAL BEACH
State : CA
Zip : 90740-6164
Country : US
Telephone Number : 972-693-2210
Fax Number :
Provider Business Practice Location Address
First Line : 4117 SOUTH ST
Second Line :
City : LAKEWOOD
State : CA
Zip : 90712-1043
Country : US
Telephone Number : 714-734-8654
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2013
Last Update Date : 01/07/2015

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