Provider Demographics
NPI:1154438372
Name:JAMSHIDI, ALI (MD)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:JAMSHIDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 OHUA AVE
Mailing Address - Street 2:TOWER 2 APT 1909
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-3653
Mailing Address - Country:US
Mailing Address - Phone:646-345-9452
Mailing Address - Fax:
Practice Address - Street 1:201 OHUA AVE
Practice Address - Street 2:TOWER 2 APT 1909
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-3653
Practice Address - Country:US
Practice Address - Phone:646-345-9452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD13375207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00 B 0253811OtherKUAKINI HOSPITAL
HI57079801Medicaid
HI0000253815OtherSAINT FRANCIS WEST HOSPIT
HI57079803Medicaid
HI00A0253813OtherSAINT FRANCIS LILIHA
HI57079802Medicaid
HI00A0253813OtherSAINT FRANCIS LILIHA
HI57079801Medicaid