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General NPI Number Information
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NPI Number | 1548443971
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Entity Type | Organization
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Legal Business Name | HUSSAIN AL-DARSANI A PROFESSIONAL CORP
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 5562 PHILADELPHIA ST STE 203
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City | CHINO
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State | CA
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Zip | 91710-2482
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Country | US
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Telephone | 909-287-0440
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Fax | 909-287-0145
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Provider Business Mailing Address
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Address Line | PO BOX 487
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City | UPLAND
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State | CA
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Zip | 91785-0487
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Country | US
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Telephone | 909-287-0440
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. HUSSAIN AL-DARSANI
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Credential | M.D.
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Telephone | 909-287-0440
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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 |
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License Number State |
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