Organization
UNIVERSITY MUSLIM MEDICAL ASSOCIATION INC
Active
Other names
UMMA Community Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ALFREDO REYNOSO (CHIEF OPERATING OFFICER)
(323) 313-5588
Entity
Organization
Contact information
Practice address
711 W FLORENCE AVE, LOS ANGELES, CA 90044
(323) 789-5610
(323) 789-5616
Mailing address
711 W FLORENCE AVE, LOS ANGELES, CA 90044
(323) 789-5610
(323) 789-5616
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051099
MEDICARE PROVIDER NUMBER
CA
05
—
BCP70908F
—
CA
05
—
EAP70908F
—
CA
05
—
FHC70908F
—
CA
01
—
H701898
PUBLIC PRIVATE PARTNERSHI
CA
05
—
HAP70908F
—
CA
Enumeration date
10/02/2006
Last updated
05/23/2024
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