Provider Demographics
NPI:1669561536
Name:DANA, ALI PARDIS (MD)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:PARDIS
Last Name:DANA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 W GONZALES RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-3072
Mailing Address - Country:US
Mailing Address - Phone:805-983-0691
Mailing Address - Fax:805-983-1331
Practice Address - Street 1:1200 W GONZALES RD
Practice Address - Street 2:SUITE 300
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-3072
Practice Address - Country:US
Practice Address - Phone:805-983-0691
Practice Address - Fax:805-983-1331
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2023-10-27
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Provider Licenses
StateLicense IDTaxonomies
CAA111309207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ75566ZMedicaid
CAZZZ34679ZOtherBLUE CROSS
CA110039977OtherRAILROAD MEDICARE
CAZZZ75566ZMedicaid