Basic Information
| Provider Information | |||||||||
| NPI: | 1306814868 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MESIWALA | ||||||||
| FirstName: | ALI | ||||||||
| MiddleName: | HAKIM | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 840 TOWNE CENTER DR | ||||||||
| Address2: | |||||||||
| City: | POMONA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917675900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9093981550 | ||||||||
| FaxNumber: | 9093981488 | ||||||||
| Practice Location | |||||||||
| Address1: | 9170 HAVEN AVE STE 108 | ||||||||
| Address2: | |||||||||
| City: | RANCHO CUCAMONGA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917305416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9099489754 | ||||||||
| FaxNumber: | 9099488960 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2006 | ||||||||
| LastUpdateDate: | 09/13/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | MD00042260 | WA | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | A87133 | CA | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.