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General NPI Number Information
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NPI Number | 1033942628
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Entity Type | Organization
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Legal Business Name | UNIVERSITY MUSLIM MEDICAL ASSOCIATION INC
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Dates
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Enumeration Date | 08/21/2024
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Last Update Date | 04/19/2025
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Provider Practice Location Address
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Address Line | 10421 S FIGUEROA ST
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City | LOS ANGELES
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State | CA
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Zip | 90003-4423
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Country | US
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Telephone | 323-789-5610
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Fax | 323-789-5616
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Provider Business Mailing Address
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Address Line | 6814 PACIFIC BLVD
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-4197
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Country | US
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Telephone | 323-789-5610
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Fax | 323-789-5616
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | ALFREDO REYNOSO
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Credential |
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Telephone | 323-647-1520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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