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Organization

MED-PRO FAMILY CLINIC, A MEDICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SAYEEDA SULTANA MD (MEDICAL DIRECTOR)
(310) 635-3800
Entity
Organization

Contact information

Practice address
221 E. GLENOAKS BLVD., 130, GLENDALE, CA 91207
(818) 549-1713
(818) 549-1716
Mailing address
11017 S. ATLANTIC AVE., 1ST FLOOR, LYNWOOD, CA 90262
(310) 635-3800
(310) 635-5448

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A36908
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0085430
CA
Enumeration date
10/10/2006
Last updated
08/22/2020
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