Provider Demographics
NPI:1710773668
Name:MOHAMMAD HUSSAIN PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER NURSING
Entity type:Organization
Organization Name:MOHAMMAD HUSSAIN PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER NURSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:213-361-2636
Mailing Address - Street 1:1335 3/4 N EDGEMONT ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5911
Mailing Address - Country:US
Mailing Address - Phone:213-361-2636
Mailing Address - Fax:
Practice Address - Street 1:1335 3/4 N EDGEMONT ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5911
Practice Address - Country:US
Practice Address - Phone:213-361-2636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty