Omar Ali
Individual provider Active NPI Driver · San Diego, CA
NPI 1811536162 · NPPES record last updated Jan 3, 2020
Key facts
- NPI
- 1811536162
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 6189 University Ave
San Diego, CA 92115-5720 - Phone
- (619) 200-3403
- NPI assigned
- Jan 3, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Express Ride Transport | Current |
Accepting new patients |
Locations
6189 University Ave
San Diego, CA 92115
Phone (619) 200-3403
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
6189 University Ave
San Diego, CA 92115-5720
Mailing address
6189 University Ave
San Diego, CA 92115-5720
Phone (619) 200-3403
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 343900000X | Other | CA | NON EMERGENCY MEDICAL TRANSPORT |
| 343900000X | Medicaid | CA |
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.