NPIMap

Organization Active NPI

University Muslim Medical Association Inc

Doing business as Locke Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1023831450
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
UNIVERSITY MUSLIM MEDICAL ASSOCIATION INC
Doing business as
Locke Wellness Center
Practice address
316 E 111TH St
Los Angeles, CA 90061-3004
Phone
(323) 789-5610
Fax
(323) 789-5616
NPI assigned
Nov 4, 2024
Last updated
Nov 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alfredo Reynoso
Title
Chief Operating Officer
Phone
(233) 313-5588

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

316 E 111TH St
Los Angeles, CA 90061-3004

Mailing address

6814 Pacific Blvd
Huntington Park, CA 90255-4197
Phone (323) 647-1520

Other names 1

  • Locke Wellness Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
University Muslim Medical Association Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1023831450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6814 PACIFIC BLVD",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902554197",
            "telephone_number": "323-647-1520",
            "fax_number": "323-789-5616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 E 111TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900613004",
            "telephone_number": "323-789-5610",
            "fax_number": "323-789-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY MUSLIM MEDICAL ASSOCIATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "REYNOSO",
        "authorized_official_first_name": "ALFREDO",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "233-313-5588"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Locke Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.