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NPI Code Detail

MEDICARE: MUDI LI MA

MEDICARE: MUDI LI MA
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
1390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1770418311
Entity Type Code : Individual
Provider Name (Legal Business Name) : MUDI LI MA
Provider Business Mailing Address
First Line : 271 N MADISON AVE APT 279
Second Line :
City : PASADENA
State : CA
Zip : 91101-4469
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2550 E FOOTHILL BLVD FL 2
Second Line :
City : PASADENA
State : CA
Zip : 91107-3406
Country : US
Telephone Number : 626-254-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2026
Last Update Date : 06/16/2026

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Directions to “ MUDI LI MA” Practice Location

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