Provider Demographics
NPI:1184884116
Name:BARI, ALI SINA (MD)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:SINA
Last Name:BARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6671
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95406-0671
Mailing Address - Country:US
Mailing Address - Phone:707-473-0220
Mailing Address - Fax:707-473-0990
Practice Address - Street 1:2300 HENRY AVE
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-1714
Practice Address - Country:US
Practice Address - Phone:510-984-1103
Practice Address - Fax:888-628-9895
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPENDING208600000X
CAA104654208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery