Individual provider Active NPI

Ashim Haydar Ali

  • Radiologic Technologist
  • Stockton, CA
National Provider Identifier
1427401512
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiologic TechnologistTaxonomy code 247100000X
License
RHF00100912 Issued in CA
Practice address
4578 Feather River Dr Ste B
Stockton, CA 95219-6510
Phone
(619) 646-0416
NPI assigned
Jul 13, 2016
Last updated
Dec 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic Technologist 247100000X RHF00100912 CA Primary

Addresses

Primary practice location

4578 Feather River Dr Ste B
Stockton, CA 95219-6510

Mailing address

6333 Pacific Ave # 544
Stockton, CA 95207-3713
Phone (619) 646-0416

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RHF00100912CAMDRadiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Vision LLC CurrentSince Jul 20, 2021 Accepting new patients

Locations

4578 Feather River Dr
Ste B
Stockton, CA 95219
Phone (619) 646-0416

6333 Pacific Ave
Stockton, CA 95207
Phone (209) 981-3299

8900 Thornton Rd
Ste 24
Stockton, CA 95209

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1427401512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6333 PACIFIC AVE # 544",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952073713",
            "telephone_number": "619-646-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4578 FEATHER RIVER DR STE B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952196510",
            "telephone_number": "619-646-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "ASHIM",
        "middle_name": "HAYDAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-13",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "CA",
            "license": "RHF00100912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.