Provider Demographics
NPI:1154355832
Name:ALI, USMAN M (MD)
Entity type:Individual
Prefix:DR
First Name:USMAN
Middle Name:M
Last Name:ALI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2160 W GRANT LINE RD
Mailing Address - Street 2:STE 230
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-7334
Mailing Address - Country:US
Mailing Address - Phone:209-468-6937
Mailing Address - Fax:209-468-7042
Practice Address - Street 1:2160 W GRANT LINE RD
Practice Address - Street 2:STE 230
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95377-7334
Practice Address - Country:US
Practice Address - Phone:209-832-8700
Practice Address - Fax:209-832-2210
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2017-09-08
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Provider Licenses
StateLicense IDTaxonomies
CAA50246207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF71840Medicare UPIN
CA00A502463Medicare ID - Type Unspecified