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General NPI Number Information
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NPI Number | 1205274768
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Entity Type | Individual
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Provider Name | HUSSEIN ABIDALI DO
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Gender | Male
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Dates
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Enumeration Date | 06/06/2013
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Last Update Date | 12/04/2020
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Provider Practice Location Address
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Address Line | 7974 HAVEN AVE STE 210
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3052
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Country | US
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Telephone | 909-941-0661
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Fax | 99-485-5779
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Provider Business Mailing Address
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Address Line | 12223 HIGHLAND AVE # 106-549
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-2574
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Country | US
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Telephone | 909-941-0661
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Fax | 909-948-5577
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 20A18140
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License Number State | CA
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