Provider Demographics
NPI:1811097843
Name:ALI, WAZIR (MD)
Entity type:Individual
Prefix:
First Name:WAZIR
Middle Name:
Last Name:ALI
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 1:13132 STUDEBAKER ROAD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650
Mailing Address - Country:US
Mailing Address - Phone:562-863-1012
Mailing Address - Fax:562-868-0916
Practice Address - Street 1:13132 STUDEBAKER ROAD
Practice Address - Street 2:SUITE 9
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650
Practice Address - Country:US
Practice Address - Phone:562-863-1012
Practice Address - Fax:562-868-0916
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG83188174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG83188OtherCA STATE LICENSE
CAH08157Medicare UPIN
CAWG83188AMedicare ID - Type UnspecifiedPPIN