DR. RUSTOM ALI (NPI# 1790190155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790190155 |
| Entity Type | Individual |
| Full Name | DR. RUSTOM ALI |
| Credential | PHD |
| Practice Address |
1968 Mesquite Ave Lake Havasu City AZ 86403-5729 |
| Practice Telephone | 4807034227 |
| Mailing Telephone | 4807034227 |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2014-06-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133NN1002X |
Nutritionist Specialization: Nutrition, Education |
778154 | AZ | Dietary & Nutritional Service Providers |
| N | 174H00000X | Health Educator | 778154 | AZ | Other Service Providers |
| Street Address |
1968 MESQUITE AVE |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86403-5729 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811396757 | Integrated Wellness Club | Health Educator | 1968 Mesquite Ave, Lake Havasu City, AZ 86403-5729 | 2014-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104479039 | Liska's Apothecary Shop, Inc. | Assisted Living Facility | 1840 Mesquite Ave., Ste. E, Lake Havasu City, AZ 86403 | 2019-07-19 |
| 1275033227 | Ayad Costy | Pharmacist | 75 North Lake Havasu City, Lake Havasu City, AZ 86403 | 2018-02-16 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 1063965036 | Cerner Health Connections, Inc | Clinic/Center | 89 Civic Center Blvd, Lake Havasu City, AZ 86403 | 2016-07-26 |
| 1447643358 | Lundin Dental PC | Durable Medical Equipment & Medical Supplies | 1741 Mesquite Avenue Ste B 100, Lake Havasu City, AZ 86403 | 2015-03-17 |
| 1912301425 | Arizona Havasu Bdm Pak LLC | Dentist | 1799 North Kiowa Blvd, Unit 109, Lake Havasu, AZ 86403 | 2014-10-13 |
| 1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
| 1750700589 | Thomas Wennergren | Pharmacist | 25 S Lake Havasu Ave, Lake Havasu City, AZ 86403 | 2014-04-09 |
| 1285997460 | Jamie L Lemire | Pharmacist | 1980 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2012-06-21 |
| 1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
| Find all providers in zip 86403 | ||||
| Taxonomy Code | 133NN1002X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Nutritionist |
| Specialization | Nutrition, Education |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029385 | Charlotte Marie Mcintyre | Nutritionist | 1000 E Water St Apt 7, Tucson, AZ 85719-3075 | 2020-10-01 |
| 1881219707 | Gabrielle Hungate | Nutritionist | 10754 N Chapin Ct, Tucson, AZ 85737-6634 | 2020-06-16 |
| 1538780598 | Penny Jean Stadick | Nutritionist | 20259 N Ryans Trl, Maricopa, AZ 85138-2446 | 2020-04-30 |
| 1275099020 | David Medansky | Nutritionist | 11980 W Shifting Sands Dr, Peoria, AZ 85383-2623 | 2019-02-18 |
| 1306345780 | Christine Inez Cintron | Nutritionist | 9231 E Carol Ave, Mesa, AZ 85208-2497 | 2018-02-12 |
| 1285143115 | Charles Higgins Jr. | Nutritionist | 600 N 4th St Apt 272, Phoenix, AZ 85004-4485 | 2017-09-22 |
| 1326568486 | Damian Dube | Nutritionist | 1503 N Rockwell St, Gilbert, AZ 85234-1436 | 2017-06-20 |
| 1427593391 | Martha Imelda Huizar | Nutritionist | 2214 E Vera Cruz Vis, Tucson, AZ 85713-5199 | 2016-12-30 |
| 1639622434 | Jenny Woelk | Nutritionist | 2757 S Pewter Dr, 102, Gilbert, AZ 85295-1282 | 2016-07-27 |
| 1356790158 | Banner Umc Dpec | Nutritionist | 3950 S Country Club Road, Suite 130, Tucson, AZ 85714 | 2016-06-13 |
| Find all providers with the same taxonomy | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86403 |
Please comment or provide details below to improve the information on DR. RUSTOM ALI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.