Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 61153 | CA |
NPI | 1063839751 |
---|---|
Provider Name | Hany Youssef |
First Address | Encino, CA 91436-1678 |
Second Address | Oxnard, CA 93030-5917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2014 |
Last Update Date | 20/03/2014 |