Individual
DR. ALI KHAZAEI NEZHAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
742 W HIGHLAND AVE, SAN MARCOS MEDICAL GROUP INC., SAN BERNARDINO, CA 92405-3839
(312) 953-9909
(909) 881-7330
Mailing address
27652 HOMESTEAD RD, LAGUNA NIGUEL, CA 92677-6603
(312) 953-9909
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A108351
CA
207VG0400X
Gynecology Physician
250973
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110093581A
—
MA
Enumeration date
06/18/2007
Last updated
10/03/2024
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