Healthcare Provider Details

I. General information

NPI: 1457744476
Provider Name (Legal Business Name): COMMUNITY MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2015
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8540 ALONDRA BLVD STE B2
PARAMOUNT CA
90723-5200
US

IV. Provider business mailing address

8540 ALONDRA BLVD STE B2
PARAMOUNT CA
90723-5200
US

V. Phone/Fax

Practice location:
  • Phone: 562-602-2508
  • Fax: 562-602-2382
Mailing address:
  • Phone: 562-602-2508
  • Fax: 562-602-2382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: HABIB J HASHMANI
Title or Position: CEO
Credential:
Phone: 562-602-2508