Provider Demographics
NPI:1386670438
Name:RONAGHY, HOSSAIN ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:HOSSAIN
Middle Name:ALI
Last Name:RONAGHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HOSSAIN
Other - Middle Name:ALI
Other - Last Name:RONAGHY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3023 BUNKER HILL ST
Mailing Address - Street 2:#106
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-5706
Mailing Address - Country:US
Mailing Address - Phone:619-275-2700
Mailing Address - Fax:858-270-0011
Practice Address - Street 1:3023 BUNKER HILL ST
Practice Address - Street 2:#106
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-5706
Practice Address - Country:US
Practice Address - Phone:619-275-2700
Practice Address - Fax:858-270-0011
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC39525207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6998726Medicaid
CAA89083Medicare UPIN