Healthcare Provider Details

I. General information

NPI: 1205368289
Provider Name (Legal Business Name): AFSHAN HUSAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 CALIFORNIA ST STE 1400
SAN FRANCISCO CA
94104-2116
US

IV. Provider business mailing address

425 CALIFORNIA ST STE 1400
SAN FRANCISCO CA
94104-2116
US

V. Phone/Fax

Practice location:
  • Phone: 831-484-7713
  • Fax: 650-360-0447
Mailing address:
  • Phone: 831-484-7713
  • Fax: 650-360-0447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME177962
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036.157749
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA174215
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: