Basic Information
Provider Information
NPI: 1083935878
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAGHIAN
FirstName: ALI
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1430 TULANE AVE
Address2: # 8578
City: NEW ORLEANS
State: LA
PostalCode: 701122632
CountryCode: US
TelephoneNumber: 2252813442
FaxNumber:  
Practice Location
Address1: 18000 STUDEBAKER RD STE 800
Address2:  
City: CERRITOS
State: CA
PostalCode: 907032671
CountryCode: US
TelephoneNumber: 5627353226
FaxNumber: 5628691281
Other Information
ProviderEnumerationDate: 06/16/2010
LastUpdateDate: 10/08/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X206611LAY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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