Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | A78910 | CA |
NPI | 1003951013 |
---|---|
Provider Name | Dr. Yusra Nazar Hussain |
First Address | Palo Alto, CA 94304-1511 |
Second Address | Palo Alto, CA 94304-1511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 26/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CA118788 | MEDICARE PTAN (01) | CA |
I03276 | (02) | CA |