Provider Demographics
NPI:1891947925
Name:ALI, TAYYEBA KANWAL (MD)
Entity Type:Individual
Prefix:DR
First Name:TAYYEBA
Middle Name:KANWAL
Last Name:ALI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:TAYYEBA
Other - Middle Name:KANWAL
Other - Last Name:AHMAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:408-524-5900
Mailing Address - Fax:408-851-4019
Practice Address - Street 1:1085 W EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-1030
Practice Address - Country:US
Practice Address - Phone:408-524-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC150277207W00000X
ARE-7842207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology