Provider Demographics
NPI:1437309762
Name:HOSSEINI RIVANDI, ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:HOSSEINI RIVANDI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10910 LONG BEACH BLVD STE 103-108
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-2689
Mailing Address - Country:US
Mailing Address - Phone:323-484-0086
Mailing Address - Fax:323-844-0411
Practice Address - Street 1:8401 LONG BEACH BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-2014
Practice Address - Country:US
Practice Address - Phone:323-442-8541
Practice Address - Fax:323-442-8755
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2022-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA1142282085R0202X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology