Provider Demographics
NPI:1376629261
Name:ALI, UZMA RIFAT (MD)
Entity Type:Individual
Prefix:DR
First Name:UZMA
Middle Name:RIFAT
Last Name:ALI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16465 SIERRA LAKES PKWY
Mailing Address - Street 2:SUITE 240
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-1242
Mailing Address - Country:US
Mailing Address - Phone:909-355-3100
Mailing Address - Fax:909-355-3131
Practice Address - Street 1:16465 SIERRA LAKES PKWY
Practice Address - Street 2:SUITE 240
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-1242
Practice Address - Country:US
Practice Address - Phone:909-355-3100
Practice Address - Fax:909-355-3131
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56304174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A563040Medicaid