Provider Demographics
NPI:1912031030
Name:DIA, ALI RIDA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:RIDA
Last Name:DIA
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 1:41002 COUNTY CENTER DR
Mailing Address - Street 2:#320
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-6027
Mailing Address - Country:US
Mailing Address - Phone:951-600-6355
Mailing Address - Fax:951-600-6365
Practice Address - Street 1:41002 COUNTY CENTER DR
Practice Address - Street 2:#320
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-6027
Practice Address - Country:US
Practice Address - Phone:951-600-6355
Practice Address - Fax:951-600-6365
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA478032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry