Healthcare Provider Details

I. General information

NPI: 1235409673
Provider Name (Legal Business Name): HUSSEIN MERZA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2012
Last Update Date: 05/27/2025
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 E ONTARIO AVE STE 101
CORONA CA
92879-3508
US

IV. Provider business mailing address

260 E ONTARIO AVE STE 101
CORONA CA
92879-3508
US

V. Phone/Fax

Practice location:
  • Phone: 951-371-2411
  • Fax: 951-284-0177
Mailing address:
  • Phone: 951-371-2411
  • Fax: 951-284-0177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberA168484
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA168484
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: