Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 242108 | MA |
N | 111NI0900X | Internist | 242108 | MA |
Y | 207W00000X | Ophthalmologist | A108797 | CA |
N | 207WX0107X | Retina Specialist | A108797 | CA |
NPI | 1003072786 |
---|---|
Provider Name | Dr. Tarek Alasil |
First Address | Pasadena, CA 91105-3205 |
Second Address | Los Angeles, CA 90045-3950 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2008 |
Last Update Date | 05/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1760541569 | GROUP NPI (01) | CA |
BW463A | (02) | CA |
W20602 | (02) | CA |