Organization
UNIVERSITY MUSLIM MEDICAL ASSOCIATION INC
Active
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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