Provider Demographics
NPI:1841281409
Name:ALI, YOUNIS ARIF (MD)
Entity type:Individual
Prefix:MR
First Name:YOUNIS
Middle Name:ARIF
Last Name:ALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1234 FOOTHILL BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750
Mailing Address - Country:US
Mailing Address - Phone:909-596-4879
Mailing Address - Fax:909-596-9199
Practice Address - Street 1:1234 FOOTHILL BLVD
Practice Address - Street 2:STE 2
Practice Address - City:LA VERNE
Practice Address - State:CA
Practice Address - Zip Code:91750
Practice Address - Country:US
Practice Address - Phone:909-596-4879
Practice Address - Fax:909-596-9199
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50850207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C508500Medicaid
G49794Medicare UPIN
CAC50850Medicare ID - Type Unspecified