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MAYWOOD FAMILY MEDICAL CENTER NPI 1801184841


NPI Information

NPI: 1801184841
Provider Name: MAYWOOD FAMILY MEDICAL CENTER
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 05D0966981

Address:
5920 ATLANTIC BLVD
MAYWOOD, CA
ZIP 90270
Phone: (323) 562-2535
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MAYWOOD FAMILY MEDICAL CENTER is a clinic center in Maywood, CA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). MAYWOOD FAMILY MEDICAL CENTER NPI is 1801184841. The provider is registered as an organization entity type.

The provider's business location address is:

5920 ATLANTIC BLVD
MAYWOOD, CA
ZIP 90270-101
Phone: (323) 562-2535
Fax: (323) 562-2558

The provider's authorized official is Ragaa Z. Iskarous .
The authorized official title is Chief Executive Officer and has the following contact phone number (562) 522-7413.

The CLIA number assigned to this NPI record is 05D0966981 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/12/2011 and was last updated on 7/12/2011.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterA45155CALIFORNIAYes

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: 5/5/2024

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