Individual
DR. ALI M. ETEMADIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5343 RIVERSIDE DR, CHINO, CA 91710-4252
(909) 591-6227
(909) 591-6319
Mailing address
5343 RIVERSIDE DRIVE, CHINO, CA 91710
(909) 591-6227
(909) 591-6319
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20A6377
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX63770
—
CA
Enumeration date
09/07/2006
Last updated
07/08/2007
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