| Hussain Al-darsani M.d. A Professional Corporation | |
|
5562 Philadelphia St Ste 203 Chino CA 91710-2482 | |
| (909) 560-4683 | |
| (909) 287-0145 |
| Full Name | Hussain Al-darsani M.d. A Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 5562 Philadelphia St Ste 203, Chino, California |
| Authorized Official Name and Position | Hussain Al-darsani (OWNER) |
| Authorized Official Contact | 9092870440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hussain Al-darsani M.d. A Professional Corporation 5562 Philadelphia St Ste 203 Chino CA 91710-2482 Ph: (909) 560-4683 | Hussain Al-darsani M.d. A Professional Corporation 5562 Philadelphia St Ste 203 Chino CA 91710-2482 Ph: (909) 560-4683 |
| NPI Number | 1790958262 |
|---|---|
| Provider Enumeration Date | 04/07/2008 |
| Last Update Date | 07/18/2024 |
| Medicare PECOS PAC ID | 1456404540 |
|---|---|
| Medicare Enrollment ID | O20090807000175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790958262 | NPI | - | NPPES |
| 00A6878210 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | A687821 (California) | Primary |
| Provider Name | Hussain Al-darsani |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1669429775 PECOS PAC ID: 6507882446 Enrollment ID: I20051019001010 |
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