Provider Demographics
NPI:1528033925
Name:LASHGARI, ALI REZA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:REZA
Last Name:LASHGARI
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 1:477 N EL CAMINO REAL
Mailing Address - Street 2:SUITE A-300
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1328
Mailing Address - Country:US
Mailing Address - Phone:760-436-8700
Mailing Address - Fax:760-436-8937
Practice Address - Street 1:477 N EL CAMINO REAL
Practice Address - Street 2:SUITE A-300
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1328
Practice Address - Country:US
Practice Address - Phone:760-436-8700
Practice Address - Fax:760-436-8937
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-20
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG78121174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG32897Medicare UPIN
CAG78121CMedicare ID - Type UnspecifiedSAN DIEGO OFFICE
CAG78121Medicare ID - Type UnspecifiedENCINITAS OFFICE