Provider Demographics
NPI:1376873554
Name:MUHAMMAD J. MEMON PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MUHAMMAD J. MEMON PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:J
Authorized Official - Last Name:MEMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-639-7200
Mailing Address - Street 1:555 W COMPTON BLVD
Mailing Address - Street 2:104
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-3085
Mailing Address - Country:US
Mailing Address - Phone:310-639-7200
Mailing Address - Fax:310-639-0200
Practice Address - Street 1:555 W COMPTON BLVD
Practice Address - Street 2:104
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-3085
Practice Address - Country:US
Practice Address - Phone:310-639-7200
Practice Address - Fax:310-639-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty