Healthcare Provider Details

I. General information

NPI: 1275147068
Provider Name (Legal Business Name): HUSSEIN ABIDALI, D.O. DIGESTIVE HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2020
Last Update Date: 02/23/2021
Certification Date: 02/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7974 HAVEN AVE STE 210
RANCHO CUCAMONGA CA
91730-3052
US

IV. Provider business mailing address

7974 HAVEN AVE STE 210
RANCHO CUCAMONGA CA
91730-3052
US

V. Phone/Fax

Practice location:
  • Phone: 909-301-0550
  • Fax: 909-301-0626
Mailing address:
  • Phone: 909-941-0661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HUSSEIN ABIDALI
Title or Position: GASTROENTEROLOGIST
Credential: D.O.
Phone: 480-251-5887