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NPI Code Detail

MEDICARE: MUSTAFA FATTAH

MEDICARE: MUSTAFA FATTAH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1124962089
Entity Type Code : Individual
Provider Name (Legal Business Name) : MUSTAFA FATTAH
Provider Business Mailing Address
First Line : 250 HOSPITAL PKWY
Second Line :
City : SAN JOSE
State : CA
Zip : 95119-1103
Country : US
Telephone Number : 408-972-3000
Fax Number :
Provider Business Practice Location Address
First Line : 250 HOSPITAL PKWY
Second Line :
City : SAN JOSE
State : CA
Zip : 95119-1103
Country : US
Telephone Number : 408-972-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2026
Last Update Date : 04/20/2026

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Directions to “ MUSTAFA FATTAH ” Practice Location

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