Individual
SHAHID HUSSAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2205 ROSS AVE, STE 101, EL CENTRO, CA 92243-3623
(760) 353-0404
(760) 353-0392
Mailing address
4225 EXECUTIVE SQ STE 450, LA JOLLA, CA 92037-8411
(858) 810-0000
(858) 268-1911
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A80449
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A804490
—
CA
01
—
GL123Y
NO. CALIFORNIA PTAN
CA
01
—
GL123Z
SO. CALIFORNIA PTAN
CA
Enumeration date
12/09/2005
Last updated
02/02/2021
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