Provider Demographics
NPI:1558907857
Name:ALI ROHAM, DO INC
Entity type:Organization
Organization Name:ALI ROHAM, DO INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:949-269-7990
Mailing Address - Street 1:21163 NEWPORT COAST DR STE 1014
Mailing Address - Street 2:
Mailing Address - City:NEWPORT COAST
Mailing Address - State:CA
Mailing Address - Zip Code:92657-1123
Mailing Address - Country:US
Mailing Address - Phone:949-269-7990
Mailing Address - Fax:386-204-7376
Practice Address - Street 1:1401 AVOCADO AVE STE 501
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-8721
Practice Address - Country:US
Practice Address - Phone:949-269-7990
Practice Address - Fax:386-204-7376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-21
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty