Provider Demographics
NPI:1184823494
Name:SOVARI, ALI ALIZADEH (MD)
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:ALIZADEH
Last Name:SOVARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALI
Other - Middle Name:
Other - Last Name:ALIZADEHSOVARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:605 W MADISON ST APT 4612
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-2449
Mailing Address - Country:US
Mailing Address - Phone:217-390-3799
Mailing Address - Fax:
Practice Address - Street 1:2241 WANKEL WAY STE C
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-0191
Practice Address - Country:US
Practice Address - Phone:805-983-0922
Practice Address - Fax:805-983-1997
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102067207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology