Basic Information
| Provider Information | |||||||||
| NPI: | 1093045023 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALI | ||||||||
| FirstName: | FATIMA | ||||||||
| MiddleName: | KHALIL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 451 HEALTH SCIENCES DRIVE | ||||||||
| Address2: | SUITE 6510 | ||||||||
| City: | DAVIS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307522884 | ||||||||
| FaxNumber: | 5307546047 | ||||||||
| Practice Location | |||||||||
| Address1: | 4860 Y ST | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958172307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167342737 | ||||||||
| FaxNumber: | 9167345484 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2010 | ||||||||
| LastUpdateDate: | 01/14/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RA0201X | 11855 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Allergy & Immunology |
No ID Information.