Organization
ALI M. ETEMADIAN, D.O., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALI M. ETEMADIAN D.O. (OWNER)
(909) 591-6227
Entity
Organization
Contact information
Practice address
5343 RIVERSIDE DR, CHINO, CA 91710-4252
(909) 591-6227
(909) 591-6319
Mailing address
5343 RIVERSIDE DR, CHINO, CA 91710-4252
(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
02/08/2007
Last updated
08/22/2020
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