Provider Demographics
NPI:1275533481
Name:HUSSAIN, AHMED (MD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 MOWRY AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1626
Mailing Address - Country:US
Mailing Address - Phone:510-796-0510
Mailing Address - Fax:510-796-7760
Practice Address - Street 1:2333 MOWRY AVE STE 300
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1626
Practice Address - Country:US
Practice Address - Phone:510-796-0510
Practice Address - Fax:510-796-7760
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52122208800000X
TN43255208800000X
NY140962208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA71313Medicaid
NY00775131Medicaid
AR158825001Medicaid
TN3001480Medicaid
NYJ400059171Medicare PIN
ARA60087Medicare UPIN