Basic Information
| Provider Information | |||||||||
| NPI: | 1104866748 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUSSAIN | ||||||||
| FirstName: | FARABI | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 670 | ||||||||
| Address2: | |||||||||
| City: | REDLANDS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923730000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9097470371 | ||||||||
| FaxNumber: | 9095801363 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 N. PEPPER AVE. | ||||||||
| Address2: | SURGERY - MOB 308 | ||||||||
| City: | COLTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095803353 | ||||||||
| FaxNumber: | 9095801363 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2006 | ||||||||
| LastUpdateDate: | 07/19/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | A60613 | CA | N | Allopathic & Osteopathic Physicians | Surgery | 2086X0206X | A606130 | CA | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology | 208600000X | A606130 | CA | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 00A606131 | 05 | CA | MEDICAID | 00A606130C | 05 | CA | MEDICAID |