Healthcare Provider Details

I. General information

NPI: 1629004890
Provider Name (Legal Business Name): HUSSEIN M ABDULHADI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5965 SEVERIN DR
LA MESA CA
91942
US

IV. Provider business mailing address

5965 SEVERIN DR
LA MESA CA
91942
US

V. Phone/Fax

Practice location:
  • Phone: 619-326-0326
  • Fax: 619-326-0101
Mailing address:
  • Phone: 619-326-0326
  • Fax: 619-326-0101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberA61032
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: