Healthcare Provider Details

I. General information

NPI: 1497679096
Provider Name (Legal Business Name): MDCLINIX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 S SPRING ST #13308
LOS ANGELES CA
90013-3200
US

IV. Provider business mailing address

506 S SPRING ST #13308
LOS ANGELES CA
90013-3200
US

V. Phone/Fax

Practice location:
  • Phone: 585-312-6363
  • Fax: 585-257-0024
Mailing address:
  • Phone: 585-312-6363
  • Fax: 585-257-0024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. FAHAD ABDUL GHAFFAR
Title or Position: CEO/MANAGING MEMBER
Credential:
Phone: 585-312-6363