Provider Demographics
NPI:1649274093
Name:H. BABAALI, M.D. MEDICAL INC.
Entity type:Organization
Organization Name:H. BABAALI, M.D. MEDICAL INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMPLOYER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BABAALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-829-3385
Mailing Address - Street 1:2428 SANTA MONICA BLVD
Mailing Address - Street 2:STE 402
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2047
Mailing Address - Country:US
Mailing Address - Phone:310-829-3385
Mailing Address - Fax:310-828-6635
Practice Address - Street 1:2428 SANTA MONICA BLVD
Practice Address - Street 2:STE 402
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2047
Practice Address - Country:US
Practice Address - Phone:310-829-3385
Practice Address - Fax:310-828-6635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X, 207RC0200X, 207RP1001X
CAG86162282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1194964171OtherNPI H BABAALI MD MEDICAL INC
CA1194964171Medicaid
CA1699790584OtherNPI INDIVIDUAL
G86162AMedicare PIN
CA1194964171OtherNPI H BABAALI MD MEDICAL INC