Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A61585 | CA |
N | 111NI0900X | Internist | A61585 | CA |
N | 207RC0200X | Critical Care Medicine | A61585 | CA |
Y | 207RP1001X | Pulmonary Disease | A61585 | CA |
N | 207RS0012X | Sleep Medicine | A61585 | CA |
NPI | 1053389338 |
---|---|
Provider Name | Nadir Ali Eltahir |
First Address | Pomona, CA 91767-5900 |
Second Address | Pomona, CA 91767-3002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2006 |
Last Update Date | 13/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A615850 | (05) | CA |
H19165 | (02) | CA |