MEDICARE: DR. TAYYEBA KANWAL 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	207W00000X	Ophthalmology Physician	C150277	CA

General Provider Information

NPI Number	:	1891947925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAYYEBA KANWAL ALI M.D.

Provider Business Mailing Address
First Line	:	325 DISTEL CIR
Second Line	:
City	:	LOS ALTOS
State	:	CA
Zip	:	94022-1408
Country	:	US
Telephone Number	:	408-524-5900
Fax Number	:	408-851-4019

Provider Business Practice Location Address
First Line	:	1085 W EL CAMINO REAL
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-1030
Country	:	US
Telephone Number	:	408-524-5900
Fax Number	:

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

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	03/04/2020

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