Provider Demographics
NPI:1568629210
Name:ATAII, POOYA ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:POOYA
Middle Name:ALEXANDER
Last Name:ATAII
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9200 SCRANTON RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-7715
Mailing Address - Country:US
Mailing Address - Phone:858-481-7701
Mailing Address - Fax:858-481-7741
Practice Address - Street 1:9200 SCRANTON RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-7715
Practice Address - Country:US
Practice Address - Phone:858-481-7701
Practice Address - Fax:858-481-7741
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2023-06-15
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Provider Licenses
StateLicense IDTaxonomies
CAA87933208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33-111-4283OtherTAX ID