Provider Demographics
NPI:1376567776
Name:ALI, MIR TAQUI (MD)
Entity Type:Individual
Prefix:
First Name:MIR
Middle Name:TAQUI
Last Name:ALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:624 W DUARTE RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7603
Mailing Address - Country:US
Mailing Address - Phone:626-446-5800
Mailing Address - Fax:626-446-0214
Practice Address - Street 1:624 W DUARTE RD
Practice Address - Street 2:SUITE 207
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7603
Practice Address - Country:US
Practice Address - Phone:626-446-5800
Practice Address - Fax:626-446-0214
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA45889207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA45889OtherA45889
CAA45889OtherA45889