| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Mohammed Moazzam Hossain | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| First name | Mohammed | [sources] | |||
| Last name | Hossain | [sources] | |||
| Middle name | Moazzam | [sources] | |||
| NPI | 1679684807 · 1811252844 | [sources] | |||
| Registration number | 00A341010 · 00A341011 · 00A341012 · A 34101 | [sources] | |||
| Sector | Physician | [sources] | |||
| Address | 627 Broodside Avenue, Redlands, CA, 92373 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.
United States · DHCS
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