Organization
PARKSIDE MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHSEN IBRAHIM ALI M.D. (OWNER)
(909) 608-2008
Entity
Organization
Contact information
Practice address
1310 SAN BERNARDINO ROAD, SUITE 102, UPLAND, CA 91786-4985
(909) 608-2008
(909) 608-7705
Mailing address
1310 SAN BERNARDINO ROAD, SUITE 102, UPLAND, CA 91786-4985
(909) 608-2008
(909) 608-7705
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A101427
CA
2084N0400X
Neurology Physician
Primary
A33406
CA
Other
Enumeration date
03/03/2009
Last updated
06/18/2015
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