Healthcare Provider Details

I. General information

NPI: 1932631652
Provider Name (Legal Business Name): YOUSEF MONZER MAITA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3502 W CACTUS RD
PHOENIX AZ
85029-3127
US

IV. Provider business mailing address

3502 W CACTUS RD
PHOENIX AZ
85029-3127
US

V. Phone/Fax

Practice location:
  • Phone: 602-938-1590
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number036.174866
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number75099
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License NumberV5914
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number81365-25
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number8127
License Number StateAZ
# 6
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number20475
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: