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Organization
TAREQ A ALI MD APC
Active
Organization
TAREQ A ALI MD APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAREQ A ALI MD (PRESIDENT OF CORPORATION)
20933393797
Entity
Organization
Contact information
Practice address
1520 W KETTLEMAN LN STE B, LODI, CA 95242-9290
(209) 339-3797
(209) 339-3795
Mailing address
1520 W KETTLEMAN LN STE B, LODI, CA 95242-9290
(209) 339-3797
(209) 339-3795
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A51048
CA
Other
Enumeration date
07/13/2012
Last updated
07/13/2012
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