Healthcare Provider Details

I. General information

NPI: 1144517327
Provider Name (Legal Business Name): NUDRAT USMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2011
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 W 7TH ST
SAN PEDRO CA
90732-3505
US

IV. Provider business mailing address

2015 CADDINGTON DR
RANCHO PALOS VERDES CA
90275-2012
US

V. Phone/Fax

Practice location:
  • Phone: 310-462-5922
  • Fax:
Mailing address:
  • Phone: 310-462-5922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA117296
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: