Organization Active NPI

Hussain Al-Darsani M.D. a Professional Corporation

  • Gastroenterology Physician
  • Chino, CA
National Provider Identifier
1790958262
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A687821 Issued in CA
Legal business name
HUSSAIN AL-DARSANI M.D. A PROFESSIONAL CORPORATION
Practice address
5562 Philadelphia St Ste 203
Chino, CA 91710-2482
Phone
(909) 560-4683
Fax
(909) 287-0145
NPI assigned
Apr 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Hussain Al-DarsaniNPI 1669429775
Title
Owner
Phone
(909) 287-0440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X A687821 CA Primary

Addresses

Primary practice location

5562 Philadelphia St Ste 203
Chino, CA 91710-2482

Mailing address

5562 Philadelphia St Ste 203
Chino, CA 91710-2482
Phone (909) 560-4683

Other identifiers 1

IdentifierTypeStateIssuer
00A6878210MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090807000175 CA Part B Supplier - Clinic/Group Practice 1456404540 Receives reassigned benefits from 1 practitioner
Practice locations: Chino, CA

National Provider Directory

National Provider Directory
Tax ID family
Hussain Al Darsani MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1790958262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5562 PHILADELPHIA ST STE 203",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102482",
            "telephone_number": "909-560-4683",
            "fax_number": "909-287-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5562 PHILADELPHIA ST STE 203",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102482",
            "telephone_number": "909-560-4683",
            "fax_number": "909-287-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUSSAIN AL-DARSANI M.D. A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "AL-DARSANI",
        "authorized_official_first_name": "HUSSAIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-287-0440",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A687821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A6878210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.