Individual
DR. SANUSI HAMBALI UMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
819 N HARBOR DR, SUITE 400, REDONDO BEACH, CA 90277-2006
(310) 480-0490
(310) 318-1590
Mailing address
819 N HARBOR DR, SUITE 400, REDONDO BEACH, CA 90277-2006
(310) 480-0490
(310) 318-1590
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A067317
CA
207NS0135X
Procedural Dermatology Physician
A067317
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A067317
CALIFORNIA STATE LICENSE
CA
Enumeration date
10/02/2006
Last updated
12/11/2008
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