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NPI Code Detail

MEDICARE: SANDAL HUSSAIN MD

MEDICARE: SANDAL HUSSAIN MD
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
12080P0204XPediatric Emergency Medicine (Pediatrics) PhysicianA171791CA

General Provider Information

NPI Number : 1811381825
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDAL HUSSAIN MD
Provider Business Mailing Address
First Line : 3400 DATA DR
Second Line :
City : RANCHO CORDOVA
State : CA
Zip : 95670-7956
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 830 JEFFERSON AVE STE M
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94063-1804
Country : US
Telephone Number : 650-861-0616
Fax Number : 650-381-0617
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2015
Last Update Date : 01/05/2024

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