Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | A54187 | CA |
NPI | 1215953278 |
---|---|
Provider Name | Afshan Ashraf Ali |
First Address | Fountain Valley, CA 92728-8185 |
Second Address | Fountain Valley, CA 92708-4019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4762434 | MEDICAL PROVIDER NUMBER (01) | CA |
G22994 | (02) | CA |