Organization
UNIVERSITY MUSLIM MEDICAL ASSOCIATION INC
Active
Other names
Locke Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
ALFREDO REYNOSO (CHIEF OPERATING OFFICER)
(233) 313-5588
Entity
Organization
Contact information
Practice address
316 E 111TH ST, LOS ANGELES, CA 90061-3004
(323) 789-5610
(323) 789-5616
Mailing address
6814 PACIFIC BLVD, HUNTINGTON PARK, CA 90255-4197
(323) 647-1520
(323) 789-5616
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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