Individual provider · NPI-1

Qayyum Abdulmalik

Counselor, Addiction (Substance Use Disorder) · Los Angeles, CA

NPI number1023733284
StatusActive
Last updated in NPPESOct 10, 2022

Details

NPI
1023733284
Entity type
Individual (NPI-1)
Name
Qayyum Abdulmalik
Sex
Male
Sole proprietor
No
Enumeration date
Oct 10, 2022
Certification date
Oct 10, 2022
Last updated
Oct 10, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YA0400X Counselor, Addiction (Substance Use Disorder)––Yes

Practice location

4445 Burns Ave
Los Angeles, CA 90029-2702

Phone 323-222-1440

Mailing address

4445 Burns Ave
Los Angeles, CA 90029-2702

Phone 323-222-1440

Other practice locations

11027 Burbank Blvd
North Hollywood, CA 91601-2431

Phone 818-985-8323

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