| Aldiwani Medical Group Corporation | |
|
11409 Windy Summit Pl San Diego CA 92127-2049 | |
| (832) 371-3279 | |
| (619) 939-4556 |
| Full Name | Aldiwani Medical Group Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 11409 Windy Summit Pl, San Diego, California |
| Authorized Official Name and Position | Suzan Mahdai (OWNER) |
| Authorized Official Contact | 8323713279 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aldiwani Medical Group Corporation 11409 Windy Summit Pl San Diego CA 92127-2049 Ph: (832) 371-3279 | Aldiwani Medical Group Corporation 11409 Windy Summit Pl San Diego CA 92127-2049 Ph: (832) 371-3279 |
| NPI Number | 1003647488 |
|---|---|
| Provider Enumeration Date | 08/08/2024 |
| Last Update Date | 08/08/2024 |
| Medicare PECOS PAC ID | 7315478559 |
|---|---|
| Medicare Enrollment ID | O20240930000953 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003647488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Haider Aldiwani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396130696 PECOS PAC ID: 3870895709 Enrollment ID: I20190412001615 |
| Provider Name | Suzan Qusay Mahdai |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598015679 PECOS PAC ID: 8123332111 Enrollment ID: I20191204001082 |
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