Individual
MRS. AMENA MASOOD ALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, PA-C
Contact information
Practice address
23672 BIRTCHER DR, UNIT A, LAKE FOREST, CA 92630-1711
(949) 770-7301
(949) 770-0634
Mailing address
23672 BIRTCHER DR, UNIT A, LAKE FOREST, CA 92630-1711
(949) 770-7301
(949) 770-0634
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 19554
CA
Other
Enumeration date
01/24/2008
Last updated
12/10/2014
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