Provider Demographics
NPI:1548472574
Name:HUSSAIN, RIZWANA BEGUM (MD)
Entity type:Individual
Prefix:
First Name:RIZWANA
Middle Name:BEGUM
Last Name:HUSSAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18750 COLIMA RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-2959
Mailing Address - Country:US
Mailing Address - Phone:626-912-9345
Mailing Address - Fax:626-854-0295
Practice Address - Street 1:18750 COLIMA RD
Practice Address - Street 2:SUITE B
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-2959
Practice Address - Country:US
Practice Address - Phone:626-912-9345
Practice Address - Fax:626-854-0295
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA038923208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A389230Medicaid
CAB50392Medicare UPIN
CA00A389230Medicaid