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ATLANTIC AVENUE MEDICAL CLINIC NPI 1477550788


NPI Information

NPI: 1477550788
Provider Name: ATLANTIC AVENUE MEDICAL CLINIC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
3737 MARTIN LUTHER KING JR BLVD STE 333
LYNWOOD, CA
ZIP 90262
Phone: (323) 562-3414
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ATLANTIC AVENUE MEDICAL CLINIC is a specialist in Lynwood, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ATLANTIC AVENUE MEDICAL CLINIC NPI is 1477550788. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3737 MARTIN LUTHER KING JR BLVD STE 333
LYNWOOD, CA
ZIP 90262-528
Phone: (323) 562-3414
Fax: (323) 562-3100

The provider's authorized official is Keith Ivor Mootoo .
The authorized official title is Md and has the following contact phone number (323) 562-3414.

The enumeration date for this NPI number is 6/30/2005 and was last updated on 10/16/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistA35223CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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