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16914 Highway 14 Mojave CA 93501-1226 | |
(661) 824-2729 | |
(661) 430-5448 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 16914 Highway 14, Mojave, California |
Authorized Official Name and Position | Ashmead Ali (OWNER/PHYSICIAN) |
Authorized Official Contact | 6618242729 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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16914 Highway 14 Mojave CA 93501-1226 Ph: (661) 824-2729 | 16914 Highway 14 Mojave CA 93501-1226 Ph: (661) 824-2729 |
NPI Number | 1336433051 |
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Provider Enumeration Date | 05/31/2011 |
Last Update Date | 11/01/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336433051 | NPI | - | NPPES |
G78625 | Other | CA | LIC NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | G78625 (California) | Primary |