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Individual

ALI BANAIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8860 CENTER DRIVE, SUITE 420, LA MESA, CA 91942-3020
(619) 469-5400
(619) 464-1311
Mailing address
8860 CENTER DRIVE, SUITE 420, LA MESA, CA 91942-3020
(619) 469-5400
(619) 464-1311

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
98403
MT
207RG0100X
Gastroenterology Physician
Primary
A87308
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A873080
CA
Enumeration date
03/14/2006
Last updated
03/21/2023
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