Provider Demographics
NPI:1053313544
Name:ALI, YUSUF (MD)
Entity Type:Individual
Prefix:
First Name:YUSUF
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 E WALKER ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95963-1526
Mailing Address - Country:US
Mailing Address - Phone:530-865-5400
Mailing Address - Fax:530-865-5455
Practice Address - Street 1:116 E WALKER ST
Practice Address - Street 2:
Practice Address - City:ORLAND
Practice Address - State:CA
Practice Address - Zip Code:95963-1526
Practice Address - Country:US
Practice Address - Phone:530-865-5400
Practice Address - Fax:530-865-5455
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73465208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH29135Medicare UPIN
00A734650Medicare ID - Type Unspecified