Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | A101214 | CA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | A101214 | CA |
NPI | 1184856460 |
---|---|
Provider Name | Munira Husain |
First Address | Thousand Oaks, CA 91360-5133 |
Second Address | Thousand Oaks, CA 91360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2009 |
Last Update Date | 20/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A101214 | THE MEDICAL BAORD OF CA (01) | CA |