Organization
ADVANCED FAMILY CARE MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDOULAYE DIOP (MEDICAL DOCTOR)
(323) 588-0084
Entity
Organization
Contact information
Practice address
2704 W MANCHESTER BLVD, INGLEWOOD, CA 90305-2436
(323) 778-4310
Mailing address
2704 W MANCHESTER BLVD, INGLEWOOD, CA 90305-2436
(323) 778-4310
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
A33986
CA
261QM1300X
Multi-Specialty Clinic/Center
NMW1068
CA
261QP2300X
Primary Care Clinic/Center
G42217
CA
261QP2300X
Primary Care Clinic/Center
PA12322
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0077510
—
CA
Enumeration date
08/21/2007
Last updated
08/21/2007
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