Basic Information
| Provider Information | |||||||||
| NPI: | 1285845404 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUSSAIN | ||||||||
| FirstName: | NAMATH | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., MBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25455 BARTON ROAD | ||||||||
| Address2: | SUITE 108A | ||||||||
| City: | LOMA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095584000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 25455 BARTON RD STE 108A | ||||||||
| Address2: | |||||||||
| City: | LOMA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923543139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095584000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2007 | ||||||||
| LastUpdateDate: | 08/24/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | MT203108 | PA | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | A142618 | CA | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.