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NPI Code Detail

MEDICARE: EDGAR HUSSAIN

MEDICARE: EDGAR HUSSAIN
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
1225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
125438OTHERCALICENSE#

General Provider Information

NPI Number : 1194833350
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDGAR HUSSAIN
Provider Business Mailing Address
First Line : 262 BLOOM DR
Second Line :
City : MONTEREY PARK
State : CA
Zip : 91755-6502
Country : US
Telephone Number : 323-888-1336
Fax Number :
Provider Business Practice Location Address
First Line : 301 N LAKE AVE STE 201
Second Line :
City : PASADENA
State : CA
Zip : 91101-5120
Country : US
Telephone Number : 626-568-9115
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2006
Last Update Date : 07/08/2007

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Directions to “ EDGAR HUSSAIN ” Practice Location

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