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TAREQ ALI M.D.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1790722718

Individual Registrant:
 TAREQ  ALI M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1520 W KETTLEMAN LN SUITE B LODI, CA 95242-9290 US
Tel: 209-339-3797  Fax: 209-339-3795

Contact information for business:
1520 W KETTLEMAN LN SUITE B LODI, CA 95242-9290 US
Tel: 209-339-3797  Fax: 209-339-3795

Registration Information:
NPI: 1790722718
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
CAA51048

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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