MEDICARE: DANA YOUSSEF LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	8575	CA

General Provider Information

NPI Number	:	1902133051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA YOUSSEF LAC

Provider Business Mailing Address
First Line	:	1110 LEIGH AVE
Second Line	:	#7
City	:	SAN JOSE
State	:	CA
Zip	:	95126-4528
Country	:	US
Telephone Number	:	408-297-4248
Fax Number	:

Provider Business Practice Location Address
First Line	:	1609 MERIDIAN AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95125-5532
Country	:	US
Telephone Number	:	408-448-8818
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2009
Last Update Date	:	11/11/2009

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Directions to “ DANA YOUSSEF LAC” Practice Location

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