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Organization
LA CITY CARE PC
Active
Organization
LA CITY CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAROOQUE AZAM (NP)
(000) 000-0000
Entity
Organization
Contact information
Practice address
6715 S WESTERN AVE, LOS ANGELES, CA 90047-1837
(000) 000-0000
Mailing address
6715 S WESTERN AVE, LOS ANGELES, CA 90047-1837
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/09/2025
Last updated
01/09/2025
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