MEDICARE: DR. SYED OMAR ALI 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	207N00000X	Dermatology Physician	056951	GA
2	207N00000X	Dermatology Physician	N9338	TX
3	207NS0135X	Procedural Dermatology Physician	056951	GA
4	207NS0135X	Procedural Dermatology Physician	C197728	CA
5	207N00000X	Dermatology Physician	C197728	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DC4061	OTHER	GA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821165143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SYED OMAR ALI M.D.

Provider Business Mailing Address
First Line	:	7345 MEDICAL CENTER DR STE 310
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-1961
Country	:	US
Telephone Number	:	818-884-8044
Fax Number	:	818-884-8196

Provider Business Practice Location Address
First Line	:	7345 MEDICAL CENTER DR STE 310
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-1961
Country	:	US
Telephone Number	:	818-884-8044
Fax Number	:	818-884-8196

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

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	02/25/2025

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