Provider Demographics
NPI:1073735387
Name:COMMUNITY PRENATAL AND MEDICAL CLINIC, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:COMMUNITY PRENATAL AND MEDICAL CLINIC, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:ABRAHAM
Authorized Official - Last Name:NASSIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-582-1414
Mailing Address - Street 1:8679 W PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-2315
Mailing Address - Country:US
Mailing Address - Phone:310-553-1200
Mailing Address - Fax:310-553-1216
Practice Address - Street 1:2771 E FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-5750
Practice Address - Country:US
Practice Address - Phone:323-582-1414
Practice Address - Fax:323-582-4610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty