Provider Demographics
NPI:1396374682
Name:ALI H. MESIWALA, M.D., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ALI H. MESIWALA, M.D., A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:H
Authorized Official - Last Name:MESIWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-948-8754
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-0607
Mailing Address - Country:US
Mailing Address - Phone:909-971-9334
Mailing Address - Fax:909-575-3573
Practice Address - Street 1:9170 HAVEN AVE STE 108
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5416
Practice Address - Country:US
Practice Address - Phone:909-948-8754
Practice Address - Fax:909-948-8960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty