MEDICARE: MR. MUHAMMAD NASSER ELBGAL LCSW

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	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor	75771	CA
3	104100000X	Social Worker	75771	CA
4	1041C0700X	Clinical Social Worker	81839	CA

General Provider Information

NPI Number	:	1578728556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MUHAMMAD NASSER ELBGAL LCSW

Provider Business Mailing Address
First Line	:	350 90TH ST FL 2
Second Line	:
City	:	DALY CITY
State	:	CA
Zip	:	94015-1879
Country	:	US
Telephone Number	:	650-877-5430
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 90TH ST FL 2
Second Line	:
City	:	DALY CITY
State	:	CA
Zip	:	94015-1879
Country	:	US
Telephone Number	:	650-877-5430
Fax Number	:

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

Provider Enumeration Date	:	07/19/2008
Last Update Date	:	01/30/2020

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