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General NPI Number Information
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NPI Number | 1801245063
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Entity Type | Individual
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Provider Name | MOHAMMAD AHRAZ HUSSAIN MD
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Gender | Male
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 2218 MATHEWS AVE UNIT 6
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City | REDONDO BEACH
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State | CA
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Zip | 90278-3153
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Country | US
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Telephone | 832-469-2099
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Fax |
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Provider Business Mailing Address
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Address Line | 2218 MATHEWS AVE UNIT 6
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City | REDONDO BEACH
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State | CA
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Zip | 90278-3153
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Country | US
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Telephone | 832-469-2099
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Fax |
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | A163153
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | CDR.0005817
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A163153
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License Number State | CA
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