MEDICARE: HUSSEIN TOTACH

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1336770197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUSSEIN TOTACH

Provider Business Mailing Address
First Line	:	1271 WASHINGTON AVE STE 654
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94577-3646
Country	:	US
Telephone Number	:	415-745-0202
Fax Number	:

Provider Business Practice Location Address
First Line	:	1271 WASHINGTON AVE STE 654
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94577-3646
Country	:	US
Telephone Number	:	415-745-0202
Fax Number	:

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

Provider Enumeration Date	:	01/30/2020
Last Update Date	:	04/07/2020

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Directions to “ HUSSEIN TOTACH ” Practice Location

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