| Mawj Mustafa Kamal Al Ani, | |
|
2499 E Lakeshore Dr, Lake Elsinore, CA 92530-4411 | |
| (951) 471-4200 | |
| (951) 486-5075 |
| Full Name | Mawj Mustafa Kamal Al Ani |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 2499 E Lakeshore Dr, Lake Elsinore, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366184418 | NPI | - | NPPES |
| 124131700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME169282 (Florida) | Secondary |
| 207Q00000X | Family Medicine | A202581 (California) | Primary |
| Entity Name | Lee Memorial Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992873319 PECOS PAC ID: 8729996608 Enrollment ID: O20031118000604 |
| Entity Name | Lee Health System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942058557 PECOS PAC ID: 9335672146 Enrollment ID: O20241114001576 |
| Mailing Address | Practice Location Address |
|---|---|
| Mawj Mustafa Kamal Al Ani, 2499 E Lakeshore Dr, Lake Elsinore, CA 92530-4411 Ph: (951) 471-4200 | Mawj Mustafa Kamal Al Ani, 2499 E Lakeshore Dr, Lake Elsinore, CA 92530-4411 Ph: (951) 471-4200 |
Venus Esquivel, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2499 E Lakeshore Dr, Lake Elsinore, CA 92530 Phone: 951-471-4200 | |
J M Asprec, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 425 Diamond Dr Ste 104, Lake Elsinore, CA 92530 Phone: 951-674-8779 | |
Biplav Yadav, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 31361 Riverside Dr, Lake Elsinore, CA 92530 Phone: 844-308-5003 Fax: 760-414-3892 | |
Dr. Clint Ketchel, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 30195 Fraser Dr, Lake Elsinore, CA 92530 Phone: 951-252-2720 Fax: 760-414-3892 | |
Dr. Naimah D. Powell, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 425 Diamond Drive, Suite 105, Lake Elsinore, CA 92530 Phone: 951-674-8779 Fax: 951-674-1403 | |
Dr. Mohammad Reza Danesh, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 31581 Canyon Estates Dr, Lake Elsinore, CA 92532 Phone: 951-244-3500 Fax: 951-244-3535 |