Provider Demographics
NPI:1811902620
Name:OLIAI, ASGHAR (MD)
Entity type:Individual
Prefix:DR
First Name:ASGHAR
Middle Name:
Last Name:OLIAI
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:31103 RANCHO VIEJO RD
Mailing Address - Street 2:D2-312
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-1759
Mailing Address - Country:US
Mailing Address - Phone:949-388-8011
Mailing Address - Fax:949-388-8013
Practice Address - Street 1:27800 MEDICAL CENTER RD
Practice Address - Street 2:STE 318
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6410
Practice Address - Country:US
Practice Address - Phone:949-388-8011
Practice Address - Fax:949-388-8013
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2010-08-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC50271207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C502710Medicaid
CA00C502710Medicaid