MEDICARE: CORY KHURRAM HUSSAIN M.D.

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	40764	CO
2	207RI0200X	Infectious Disease Physician	35123218	OH
3	207R00000X	Internal Medicine Physician	C145278	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	C145278	OTHER	CA	MEDICAL LICENSE

General Provider Information

NPI Number	:	1952368409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORY KHURRAM HUSSAIN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 276950
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-6950
Country	:	US
Telephone Number	:	415-600-4900
Fax Number	:	415-369-1365

Provider Business Practice Location Address
First Line	:	45 CASTRO ST STE 125
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94114-1032
Country	:	US
Telephone Number	:	415-600-4900
Fax Number	:	415-369-1365

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	01/14/2025

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