Individual
ALI REZA MIRHOSSEINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1530 BESSIE AVE STE 101, TRACY, CA 95376-3080
(209) 832-0343
(209) 464-2684
Mailing address
415 E HARDING WAY STE D, STOCKTON, CA 95204-6118
(209) 944-5750
(209) 464-2684
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036135296
IL
207RC0000X
Cardiovascular Disease Physician
Primary
A163378
CA
Other
Enumeration date
06/20/2011
Last updated
10/16/2019
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