Provider Demographics
NPI:1902854391
Name:ALI, SYED ASIF (OD (OPTOMETRIST))
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:ASIF
Last Name:ALI
Suffix:
Gender:M
Credentials:OD (OPTOMETRIST)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 S BRADLEY RD
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-8001
Mailing Address - Country:US
Mailing Address - Phone:805-925-1092
Mailing Address - Fax:805-925-4664
Practice Address - Street 1:1700 S BRADLEY RD
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-8001
Practice Address - Country:US
Practice Address - Phone:805-925-1092
Practice Address - Fax:805-925-4664
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11997T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist