Provider Demographics
NPI:1831278712
Name:ALWARDI, DHIA A (MD)
Entity type:Individual
Prefix:DR
First Name:DHIA
Middle Name:A
Last Name:ALWARDI
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 1:225 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3403
Mailing Address - Country:US
Mailing Address - Phone:626-281-7775
Mailing Address - Fax:626-281-2574
Practice Address - Street 1:225 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3403
Practice Address - Country:US
Practice Address - Phone:626-281-7775
Practice Address - Fax:626-281-2574
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25184204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A251840Medicaid
CAA83193Medicare UPIN
CAA25184Medicare PIN