Organization
AUTUMN MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEHRUNISA MOHAMMEDI M.D. (CEO)
(562) 945-0252
Entity
Organization
Contact information
Practice address
9200 COLIMA RD, SUITE 207, WHITTIER, CA 90605-1814
(562) 945-0252
(562) 945-0901
Mailing address
9200 COLIMA RD, SUITE 207, WHITTIER, CA 90605-1814
(562) 945-0252
(562) 945-0901
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A84718
CA
208D00000X
General Practice Physician
A25926
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A259260
—
CA
Enumeration date
11/08/2007
Last updated
11/08/2007
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