Provider Demographics
NPI:1912783689
Name:CLINICA FAMILY HEALTH
Entity Type:Organization
Organization Name:CLINICA FAMILY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDALLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-831-1125
Mailing Address - Street 1:4525 S KLEIN AVE STE 1000
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-3839
Mailing Address - Country:US
Mailing Address - Phone:405-652-4450
Mailing Address - Fax:
Practice Address - Street 1:4525 S KLEIN AVE STE 1000
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3839
Practice Address - Country:US
Practice Address - Phone:405-652-4450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty