Provider Demographics
NPI:1659395754
Name:RIZVI, SYED ARIF ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:ARIF ALI
Last Name:RIZVI
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 1:1335 CYPRESS STREET,
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-3538
Mailing Address - Country:US
Mailing Address - Phone:909-542-2777
Mailing Address - Fax:909-394-1800
Practice Address - Street 1:1335 CYPRESS STREET,
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-3538
Practice Address - Country:US
Practice Address - Phone:909-542-2777
Practice Address - Fax:909-394-1800
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0954046364174400000X
CAA36388207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP.A.-C 13719OtherVINCENT TRISTAN, P.A.-C
CAA84879Medicare UPIN
CAI04401Medicare UPIN
CAP.A.-C 13719OtherVINCENT TRISTAN, P.A.-C
CAB51558Medicare UPIN
CAE88037Medicare UPIN