MEDICARE: MOHAMMAD HUSSAIN PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER NURSING SERVICES CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1710773668
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOHAMMAD HUSSAIN PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER NURSING SERVICES CORPORATION

Provider Business Mailing Address
First Line	:	1335 3/4 N EDGEMONT ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5911
Country	:	US
Telephone Number	:	213-361-2636
Fax Number	:

Provider Business Practice Location Address
First Line	:	1335 3/4 N EDGEMONT ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5911
Country	:	US
Telephone Number	:	213-361-2636
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MOHAMMAD HUSSAIN
Credential	:	NP
Telephone Number	:	213-361-2636

Provider Enumeration Date	:	04/17/2025
Last Update Date	:	06/17/2025

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