Individual
MR. ALI MOHAMAD AWADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11633 HAWTHORNE BLVD, SUITE 100, HAWTHORNE, CA 90250-2321
(310) 355-0054
(310) 355-0293
Mailing address
1435 E SYCAMORE AVE, EL SEGUNDO, CA 90245
(310) 355-0054
(310) 355-0293
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A76844
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A768440
BLUE SHIELD
CA
05
—
00A768440
—
CA
Enumeration date
07/16/2006
Last updated
07/26/2007
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