Organization
DIABLO PAIN MANAGEMENT, PROF CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIR E ALI M.D. (SOLE OWNER)
(800) 883-7243
Entity
Organization
Contact information
Practice address
200 PORTER DR STE 100, SAN RAMON, CA 94583-1524
(800) 883-7243
Mailing address
210 N TUSTIN AVE, SANTA ANA, CA 92705-3807
(800) 883-7243
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A73147
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417912726
NPI TYPE 1
—
Enumeration date
07/28/2006
Last updated
08/22/2020
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