Healthcare Provider Details

I. General information

NPI: 1467154344
Provider Name (Legal Business Name): MATEEN BADER QADRI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 SKYPARK DR STE 100
TORRANCE CA
90505-5034
US

IV. Provider business mailing address

3333 SKYPARK DR STE 100
TORRANCE CA
90505-5034
US

V. Phone/Fax

Practice location:
  • Phone: 310-784-6300
  • Fax:
Mailing address:
  • Phone: 310-784-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA208392
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: