| Universal Medical Clinic, Inc. | |
|
18701 Sherman Way Reseda CA 91335-4045 | |
| (310) 323-9999 | |
| Not Available |
| Full Name | Universal Medical Clinic, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 18701 Sherman Way, Reseda, California |
| Authorized Official Name and Position | Gholam R Hosseinian (PHYSICIAN) |
| Authorized Official Contact | 3103239999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Universal Medical Clinic, Inc. 18701 Sherman Way Reseda CA 91335-4045 Ph: (310) 323-9999 | Universal Medical Clinic, Inc. 18701 Sherman Way Reseda CA 91335-4045 Ph: (310) 323-9999 |
| NPI Number | 1760671077 |
|---|---|
| Provider Enumeration Date | 10/23/2007 |
| Last Update Date | 10/23/2007 |
| Medicare PECOS PAC ID | 6507941317 |
|---|---|
| Medicare Enrollment ID | O20080304000420 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760671077 | NPI | - | NPPES |
| 00A724850 | Medicaid | CA | |
| 00A521780 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Gholam Reza Hosseinian |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1124042882 PECOS PAC ID: 1355387614 Enrollment ID: I20050708000132 |
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