Organization · NPI-2

Fma Family Practice INC

Family Medicine · Moorpark, CA

NPI number1114308343
StatusActive
Last updated in NPPESSep 22, 2015

Details

NPI
1114308343
Entity type
Organization (NPI-2)
Legal business name
Fma Family Practice INC
Organization subpart
No
Enumeration date
Jun 12, 2015
Last updated
Sep 22, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine20A11553CAYes

Other names

  • Patriot Family Medicine (Doing Business As)

Practice location

885 Patriot Dr
Unit F
Moorpark, CA 93021-3361

Phone 805-334-1371

Mailing address

885 Patriot Dr
Unit F
Moorpark, CA 93021-3361

Phone 805-334-1371

Authorized official

Fadel Abdulhai
Physician
3107384975

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