Healthcare Provider Details
I. General information
NPI: 1033060488
Provider Name (Legal Business Name): ASADULLAH AQIL ALGERE MEDI-CAL PSS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/03/2026
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1282 MARKET ST
SAN FRANCISCO CA
94102-4801
US
IV. Provider business mailing address
1321 40TH ST APT 118
EMERYVILLE CA
94608-3690
US
V. Phone/Fax
- Phone: 415-579-3021
- Fax:
- Phone: 415-579-3021
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | MPSS-LNESAK |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: