Provider Demographics
NPI:1225229248
Name:UNIVERSITY MUSLIN MEDICAL ASSOCIATION, INC.
Entity Type:Organization
Organization Name:UNIVERSITY MUSLIN MEDICAL ASSOCIATION, INC.
Other - Org Name:UMMA COMMUNITY CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:YASSER
Authorized Official - Middle Name:
Authorized Official - Last Name:AMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:323-967-0375
Mailing Address - Street 1:711 W FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90044-6105
Mailing Address - Country:US
Mailing Address - Phone:323-967-0375
Mailing Address - Fax:
Practice Address - Street 1:711 W FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90044-6105
Practice Address - Country:US
Practice Address - Phone:323-967-0375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97446261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health