Provider Demographics
NPI:1053125583
Name:MBAI, ADA
Entity type:Individual
Prefix:
First Name:ADA
Middle Name:
Last Name:MBAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 N SOLANO PRIVADO APT B
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-6845
Mailing Address - Country:US
Mailing Address - Phone:412-537-8982
Mailing Address - Fax:
Practice Address - Street 1:1110 N SOLANO PRIVADO APT B
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-6845
Practice Address - Country:US
Practice Address - Phone:412-537-8982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95130790163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical