MEDICARE: DR. SYED MAKSUDUL HOSSAIN M.D.

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
1	207R00000X	Internal Medicine Physician	A97737	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A97737	OTHER	CA	CALIFORNIA MEDICAL LICENS

General Provider Information

NPI Number	:	1154546497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SYED MAKSUDUL HOSSAIN M.D.

Provider Business Mailing Address
First Line	:	266 S HARVARD BLVD
Second Line	:	SUITE 210
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-4372
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	266 S HARVARD BLVD
Second Line	:	SUITE 210
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-4372
Country	:	US
Telephone Number	:	818-343-2775
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	11/02/2021

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