Healthcare Provider Details

I. General information

NPI: 1639036080
Provider Name (Legal Business Name): BLESSED CARE FAMILY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 S CENTRAL AVE
GLENDALE CA
91204-2503
US

IV. Provider business mailing address

1217 S CENTRAL AVE
GLENDALE CA
91204-2503
US

V. Phone/Fax

Practice location:
  • Phone: 818-250-0090
  • Fax:
Mailing address:
  • Phone: 818-250-0090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: TALAL AL-QURAINI
Title or Position: CEO
Credential: MD
Phone: 818-925-0090