Provider Demographics
NPI:1417991308
Name:ALI, KAREIM H (MD)
Entity Type:Individual
Prefix:
First Name:KAREIM
Middle Name:H
Last Name:ALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 OCEANGATE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4302
Mailing Address - Country:US
Mailing Address - Phone:562-499-6191
Mailing Address - Fax:877-778-8365
Practice Address - Street 1:107 N MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-6561
Practice Address - Country:US
Practice Address - Phone:951-358-0141
Practice Address - Fax:877-778-8365
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85376207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP01282958-DU4034OtherRAILROAD MEDICARE
CA00A853760OtherMEDI-CAL
CA00A853760Medicaid
CAWA853768Medicare PIN
CA00A853760Medicaid
CAFZ680ZMedicare PIN
CAWA85376BMedicare PIN
CA00A853762Medicare PIN
CA00A853760Medicare PIN
CA00A853760OtherMEDI-CAL
CA00A853764Medicare PIN