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Individual

DR. ALI SHAHZAD GHAJAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1361 E 4TH ST, ONTARIO, CA 91764-3035
(909) 933-3531
(909) 933-3533
Mailing address
1361 E 4TH ST, ONTARIO, CA 91764-3035
(909) 933-3531
(909) 933-3533

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
42417
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
B42417-01
MEDI-CAL NUMBER
CA
Enumeration date
01/17/2007
Last updated
06/11/2008
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