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NPI Code Detail

MEDICARE: ALI MOKHTARI MD

MEDICARE: ALI MOKHTARI MD
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1801425731
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALI MOKHTARI MD
Provider Business Mailing Address
First Line : 1840 PENNISTONE WAY
Second Line :
City : SNELLVILLE
State : GA
Zip : 30078-2337
Country : US
Telephone Number : 678-755-3382
Fax Number :
Provider Business Practice Location Address
First Line : 1364 CLIFTON RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30322-1059
Country : US
Telephone Number : 404-712-5227
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2020
Last Update Date : 04/03/2020

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Directions to “ ALI MOKHTARI MD” Practice Location

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