| Organization Name: | AUTUMN MEDICAL CLINIC |
| NPI Number: | 1124208087 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MEHRUNISA MOHAMMEDI (CEO) |
| Mailing Address: | 9200 Colima Rd Suite 207 Whittier |
| State: | CA US |
| Postal Code: | 906051814 |
| Phone Number: | 5629450252 |
| Fax Number: | 5629450901 |
| NPI Enumeration Date: | 11/08/2007 |
| NPI Last Update Date: | 11/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A25926 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |