MEDICARE: MAH HEALTH SERVICES LLC

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

General Provider Information

NPI Number	:	1417603259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAH HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	2218 MATHEWS AVE UNIT 6
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-3153
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2218 MATHEWS AVE UNIT 6
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-3153
Country	:	US
Telephone Number	:	832-469-2099
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MOHAMMAD AHRAZ HUSSAIN
Credential	:	MD
Telephone Number	:	832-469-2099

Provider Enumeration Date	:	03/01/2022
Last Update Date	:	10/18/2023

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