Healthcare Provider Details

I. General information

NPI: 1710823307
Provider Name (Legal Business Name): UNIVERSITY MUSLIM MEDICAL ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1761 W ROMNEYA DR STE B
ANAHEIM CA
92801-1816
US

IV. Provider business mailing address

6814 PACIFIC BLVD
HUNTINGTON PARK CA
90255-4197
US

V. Phone/Fax

Practice location:
  • Phone: 323-647-1520
  • Fax: 323-789-5616
Mailing address:
  • Phone: 323-647-1520
  • Fax: 323-789-5616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: ALEJANDRA MURILLO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 323-329-8081