Med-Pro Famliy Clinic

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

A53436 Issued in CA

Legal business name

MED-PRO FAMLIY CLINIC

Practice address

11017 Atlantic Ave
Lynwood, CA 90262-3001

Phone

(310) 635-3800

Fax

(310) 635-5448

NPI assigned

Feb 1, 2007

Organization subpart

No

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

Authorized official

Name

Sayeeda Sultana, M.D

Title

Medical Director

Phone

(310) 635-3800

Specialties & licenses 1

Addresses

Other names 1

• Med-Pro Managedment Former legal business name

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164560272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11017 ATLANTIC AVE",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623001",
            "telephone_number": "310-635-3800",
            "fax_number": "310-635-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11017 ATLANTIC AVE",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623001",
            "telephone_number": "310-635-3800",
            "fax_number": "310-635-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED-PRO FAMLIY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SULTANA",
        "authorized_official_first_name": "SAYEEDA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-635-3800",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "A53436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Med-Pro Managedment",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• McMillan Primary Care Medical
• Rebecca L McMullen
• Alize McNair-Braggs
• Erika McNeal, NP
• Med Forte Medical Group
• Medardo C. Supnet, M.D., Inc
• Medardo Supnet M.D. Inc
• Medicera Inc.
• Jennifer Medina, LCSW
• Sara Medina

• All providers in Lynwood, CA
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.