Healthcare Provider Details

I. General information

NPI: 1134055999
Provider Name (Legal Business Name): ABSOODMEDGROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3718 CLIFTON PL
MONTROSE CA
91020-1615
US

IV. Provider business mailing address

3718 CLIFTON PL
MONTROSE CA
91020-1615
US

V. Phone/Fax

Practice location:
  • Phone: 888-588-1947
  • Fax:
Mailing address:
  • Phone: 888-588-1947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MARY ABSOOD
Title or Position: CEO/ OWNER
Credential: MD
Phone: 888-588-1947