MEDICARE: COMMUNITY PRENATAL AND MEDICAL CLINIC, A MEDICAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1073735387
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY PRENATAL AND MEDICAL CLINIC, A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	8679 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-2315
Country	:	US
Telephone Number	:	310-553-1200
Fax Number	:	310-553-1216

Provider Business Practice Location Address
First Line	:	2771 E FLORENCE AVE
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-5750
Country	:	US
Telephone Number	:	323-582-1414
Fax Number	:	323-582-4610

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALBERT ABRAHAM NASSIR
Credential	:	M.D.
Telephone Number	:	323-582-1414

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	06/25/2026

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