Individual
ALI HAIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1130 12TH ST STE C, MODESTO, CA 95354-0834
(209) 312-2655
Mailing address
1130 12TH ST STE C, MODESTO, CA 95354-0834
(209) 312-2655
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
04/02/2024
Last updated
04/02/2024
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