Healthcare Provider Details

I. General information

NPI: 1689556714
Provider Name (Legal Business Name): MAI HUSSIEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

832 FAIRVIEW AVE APT K
ARCADIA CA
91007-6654
US

IV. Provider business mailing address

832 FAIRVIEW AVE APT K
ARCADIA CA
91007-6654
US

V. Phone/Fax

Practice location:
  • Phone: 626-800-9347
  • Fax:
Mailing address:
  • Phone: 626-800-9347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number210525
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number340335
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: