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General NPI Number Information
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NPI Number | 1699399964
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Entity Type | Organization
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Legal Business Name | UNIVERSAL MEDICAL GROUP & WEIGHT CONTROL CENTER, INC
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Dates
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Enumeration Date | 06/03/2020
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Last Update Date | 10/07/2020
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Provider Practice Location Address
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Address Line | 7119 RITA AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-4781
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Country | US
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Telephone | 323-749-6778
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Fax | 323-749-6771
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Provider Business Mailing Address
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Address Line | 7119 RITA AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-4781
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Country | US
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Telephone | 323-749-6778
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Fax | 323-749-6771
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ARTIS WOODWARD
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Credential | MD
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Telephone | 323-749-6778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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