Healthcare Provider Details

I. General information

NPI: 1962114231
Provider Name (Legal Business Name): USD CARE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 W CARSON ST STE D
TORRANCE CA
90502-2051
US

IV. Provider business mailing address

1001 W CARSON ST STE D
TORRANCE CA
90502-2051
US

V. Phone/Fax

Practice location:
  • Phone: 424-488-3544
  • Fax:
Mailing address:
  • Phone: 424-488-3544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MOHAMMED A MOHIUDDIN
Title or Position: CEO
Credential: MD
Phone: 424-488-3544