Healthcare Provider Details

I. General information

NPI: 1700297546
Provider Name (Legal Business Name): AHMED EMAD HOZAIN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 04/12/2026
Certification Date: 04/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28078 BAXTER RD STE 510
MURRIETA CA
92563-1405
US

IV. Provider business mailing address

11175 CAMPUS ST
LOMA LINDA CA
92350-1700
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-4200
  • Fax: 951-290-4944
Mailing address:
  • Phone: 909-558-4354
  • Fax: 909-558-0348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberA204796
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: