MEDICARE: ALI R. TAJIK, MD, INC

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	207Q00000X	Family Medicine Physician	A79426	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1629020268	OTHER	CA	NPI - ANAHEIM LOCATION

General Provider Information

NPI Number	:	1518074707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALI R. TAJIK, MD, INC

Provider Business Mailing Address
First Line	:	2426 S GARFIELD AVE
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-7222
Country	:	US
Telephone Number	:	323-887-9942
Fax Number	:	323-887-9949

Provider Business Practice Location Address
First Line	:	2426 S GARFIELD AVE
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-7222
Country	:	US
Telephone Number	:	323-887-9942
Fax Number	:	323-887-9949

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALI REZA TAJIK
Credential	:	MD
Telephone Number	:	323-887-9942

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	08/22/2020

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