Individual
MIR BASHARAT ALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 E BEVERLY BLVD STE 408, MONTEBELLO, CA 90640-4317
(237) 269-6063
(323) 726-9609
Mailing address
101 E BEVERLY BLVD STE 408, MONTEBELLO, CA 90640-4317
(323) 726-9606
(323) 727-1036
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A43033
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295759694
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/27/2006
Last updated
10/17/2019
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