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General NPI Number Information
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NPI Number | 1386721900
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Entity Type | Organization
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Legal Business Name | SUNSHINE MEDICAL CLINIC INC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 555 W COMPTON BLVD STE 104
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City | COMPTON
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State | CA
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Zip | 90220-3099
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Country | US
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Telephone | 310-639-7200
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Fax | 310-639-0200
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Provider Business Mailing Address
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Address Line | 555 W COMPTON BLVD STE 104
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City | COMPTON
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State | CA
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Zip | 90220-3099
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Country | US
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Telephone | 310-639-7200
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Fax | 310-639-0200
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. MUHAMMAD J MEMON
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Credential | M.D.
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Telephone | 310-639-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A66225
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License Number State | CA
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