MEDICARE: AL-MUSTAFA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1881460533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AL-MUSTAFA INC

Provider Business Mailing Address
First Line	:	18763 CEDAR CREST DR
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91387-1454
Country	:	US
Telephone Number	:	424-262-7500
Fax Number	:

Provider Business Practice Location Address
First Line	:	25429 NARBONNE AVE
Second Line	:
City	:	LOMITA
State	:	CA
Zip	:	90717-2125
Country	:	US
Telephone Number	:	142-426-2750
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ABDULLAH MUHAMED HAROON
Credential	:
Telephone Number	:	424-262-7500

Provider Enumeration Date	:	12/04/2023
Last Update Date	:	12/04/2023

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