Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A60613 | CA |
N | 208600000X | Surgeon | A60613 | CA |
Y | 208200000X | Surgeon | A606130 | CA |
Y | 208600000X | Surgeon | A606130 | CA |
N | 2086X0206X | Surgical Oncologist | A606130 | CA |
NPI | 1104866748 |
---|---|
Provider Name | Dr. Farabi M. Hussain |
First Address | Redlands, CA 92373-0000 |
Second Address | Colton, CA 92324 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 19/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A606130C | (05) | CA |
00A606131 | (05) | CA |
H40222 | (02) | CA |