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NPI Code Detail

MEDICARE: UNIVERSITY MUSLIN MEDICAL ASSOCIATION, INC.

MEDICARE: UNIVERSITY MUSLIN MEDICAL ASSOCIATION, INC.
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
1261QC1500XCommunity Health Clinic/CenterA97446CA

General Provider Information

NPI Number : 1225229248
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY MUSLIN MEDICAL ASSOCIATION, INC.
Provider Business Mailing Address
First Line : 711 W FLORENCE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90044-6105
Country : US
Telephone Number : 323-967-0375
Fax Number :
Provider Business Practice Location Address
First Line : 711 W FLORENCE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90044-6105
Country : US
Telephone Number : 323-967-0375
Fax Number :
Authorized Official
Title or Position : PRESIDENT/CEO
Name : YASSER AMAN
Credential : MPH
Telephone Number : 323-967-0375
Provider Enumeration Date : 08/05/2007
Last Update Date : 08/08/2008

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