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Individual

DR. ALI EBRAHIMI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3100 W LAKE ST, SUITE 210, MINNEAPOLIS, MN 55416-4527
(612) 925-6033
(612) 925-8496
Mailing address
3100 W LAKE ST, SUITE 210, MINNEAPOLIS, MN 55416-4527
(612) 925-6033
(612) 925-8496

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
41161
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01020059
PREFERRED ONE
MN
01
114178
UCARE
MN
01
1531615
MEDICA CHOICE
MN
01
411425197
CIGNA BEHAVIORAL HEALTH
MN
01
42F45EB
BCBS
MN
05
842220600
MN
01
HP26776
HEALTHPARTNERS
MN
01
P00284517
RR MEDICARE
MN
Enumeration date
11/10/2006
Last updated
03/07/2023
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